Alliance and compliance in tuberculosis treatment of older Pakeha people in Auckland, New Zealand.

SETTING

A community-based ethnography of tuberculosis (TB) treatment of 'European' New Zealanders in Auckland was completed in 2003.

OBJECTIVE

To document and analyse the nature of the process of care in this population where the majority of patients are older with other health and social complications.

DESIGN

Data collection included repeated semi-structured interviews with all patients who were willing and able to give consent, semi-structured interviews on health and TB with matched participants without TB, discussions with health care providers, participant observation with TB patients, readings of patient records and monitoring of TB in the media. Reiterative inductive analyses were made of transcripts, field notes and textual materials.

RESULTS

Eight patients from 2003 (out of a possible nine) and one patient from 1997 participated. All were aged 47-75 years. They represent a wide socio-economic range. All completed treatment. The contribution of multidimensional care, from initial acceptance through exigencies of treatment to successful recovery, is evident in the participants' narratives. The public health nurse is a key support and a lynchpin in the patients' support network.

CONCLUSION

A model of care including alliances between patients and care givers as part of treatment is clearly successful in this population group. This study has implications for older cohorts in other low-incidence countries.