在南非农村地区实施结核病预防治疗计划时,卫生保健工作者认为存在障碍和促进因素:使用实施研究综合框架进行内容分析
Brittney J van de Water1, Michael Wilson2,3, Karl le Roux4,5,6
1Boston College, Connell School of Nursing, Chestnut Hill, MA, USA. Brittney.vandewater@bc.edu.
Implementation science communications
|August 30, 2023
概括
南非农村地区的卫生保健工作者面临着实施结核病预防治疗 (TPT) 的挑战. 解决知识差距和资源限制对于成功的结核病接触调查和TPT计划至关重要.
科学领域:
- 公共卫生 公共卫生
- 实施科学 实施科学
- 传染病流行病学 传染病流行病学
背景情况:
- 南非国家指南与世卫组织一致,要求符合条件的个人进行家庭结核病 (TB) 接触调查和结核病预防治疗 (TPT).
- 在南非农村地区观察到TPT的实施不足,需要对潜在的障碍和促进者的调查.
研究的目的:
- 在南非东开普农村地区确定结核病接触调查和TPT管理的障碍和促进者.
- 在高负担环境中为全面的结核病计划制定实施战略提供信息.
主要方法:
- 通过19次半结构化采访,在一个地区医院和周边的初级保健诊所与医疗保健工作者进行定性数据收集.
- 实施研究综合框架 (CFIR) 指导了面试问题开发和演性内容分析.
主要成果:
- 关键障碍包括提供者对TPT有效性的知识有限,TPT文档工作流程不足以及社区资源限制.
- 促进者包括医疗保健工作者渴望了解TPT的有效性,愿意应对后勤挑战,并支持临床/护士领导的预防举措.
结论:
- 在CFIR框架中,系统地确定了影响结核病接触调查和在高结核病负担的农村地区提供TPT的决定因素.
- 持续的TPT编程需要专门的资源 (时间,培训,证据),改进的数据系统和政治/财务支持,以提高医疗保健提供者的信心和能力.
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