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了解患者体验:南非结核病治疗寻求障碍和促进者的混合方法研究
Farzana Sathar1, Claire du Toit1, Violet Chihota1,2,3
1The Aurum Institute, 33 Wrench Road, Johannesburg 1613, South Africa.
Tropical medicine and infectious disease
|October 28, 2025
概括
在南非,许多结核病患者因耻辱和其他障碍而拖延寻求护理. 提高结核病意识和伙伴关系可以帮助增加服务采用率.
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
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结核病 (TB) 仍然是南非的一个重大公共卫生挑战,危险人群对寻求护理的犹加剧了这一问题.
- 相当数量的结核病例仍未被诊断出来,这增加了该国"缺失"结核病的负担.
- 了解寻求健康的行为,障碍和耻辱对于改善结核病控制至关重要.
研究的目的:
- 探索南非结核病 (PwTB) 患者的健康寻求行为.
- 确定影响结核病寻求护理的障碍和促进者.
- 从患者和社区的角度量化结核病相关的耻辱.
主要方法:
- 在约翰内斯堡市大都会市政府进行了一项混合方法研究.
- 采访了23名经微生物学确认的肺结核开始治疗的成年人.
- 采用了主题分析和范瑞结核病耻辱评价尺度.
主要成果:
- 患者层面的障碍包括咨询传统治疗师/药剂师,误诊,工作承诺,资源稀缺,耻辱和缺乏结核病知识.
- 设施层面的障碍包括长时间的临床队列和关于结核病治疗途径的不确定性.
- 促进者包括与其他结核病患者的接触,家庭鼓励和结核病知识;中位数的耻辱评分为53 (总数),25 (社区) 和31 (患者).
结论:
- 结核病计划需要通过公私合作伙伴关系解决因结核病而寻求医疗设施前护理的问题.
- 提高社区的结核病意识,特别是在男性中,并利用移动诊所可以帮助发现病例.
- 建议与患者和提供者共同设计行为设计和干预措施,以增强结核病寻求健康的行为.
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