为什么医疗保健工作者拒绝结核病预防治疗 (TPT)? 来自印度南部的普杜切里的一个定性研究
Sadhana Subramanian1, Jilisha Gnanadhas2, Sonali Sarkar1
1Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
BMJ open respiratory research
|December 7, 2024
概括
印度的医疗保健工作者经常拒绝结核病预防治疗 (TPT),因为他们认为风险低,认识不足. 解决这些信仰和提供更短的TPT疗程的干预措施对于改善吸收和结核病根除工作至关重要.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 卫生政策 卫生政策
背景情况:
- 印度国家战略计划的目标是到2030年根除结核病 (TB),强调结核病预防治疗 (TPT).
- 医疗保健工作者 (HCW) 呈现出高的TPT拒绝率,尽管他们是结核病感染 (TBI) 的高风险群体.
- 在印度南部的普杜切里市,患有TBI的HCW中了解TPT拒绝原因对于计划的成功至关重要.
研究的目的:
- 探索被诊断患有结核病感染的卫生保健工作者拒绝结核病预防治疗的根本原因.
- 确定影响医疗保健工作者群体中TPT接受的障碍和促进者.
主要方法:
- 一项定性描述性研究,涉及12名来自第三级护理医院的经验丰富的HCW.
- 以健康信念模型为指导的深度访谈,随后进行手动主题分析.
- 最大变异抽样确保了基于部门,TBI状态和专业知识的多元参与者代表.
主要成果:
- 出现了三个主题:感知到的威胁 (低估结核病进展的个人风险),对干预措施的信念 (对益处的认识与测试挑战等感知到的障碍),以及赋权因素 (需要行政支持和更短的治疗选择).
- 尽管在工作场所暴露,医疗保健工作者对结核病进展的脆弱性感觉较低.
- 人们对TPT的好处有意识,但测试挑战和缺乏知识是显著的障碍.
结论:
- 需要有针对性的干预措施来解决医疗保健工作者对结核病风险和TPT疗效的知识差距和误解.
- 实施TPT查和治疗的医院政策,培养支持的环境,并提供更短的TPT疗程,可以提高吸收率.
- 提高医疗保健工作者对TPT的接受度对于实现国家结核病根除目标至关重要.
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