Naidoo Pamela, Dick Judy, Cooper Diane
Department of Psychology, University of the Western Cape, Bellville, South Africa.
Qual Health Res. 2009 Jan;19(1):55-70. doi: 10.1177/1049732308327893. Epub 2008 Nov 7.
Our aim with this study was to explore the factors that contribute to tuberculosis patients' adherence and nonadherence to the Directly Observed Treatment Short Course strategy. A qualitative, phenomenological research design was used. Fifteen male and female participants between the ages of 18 and 57 years were recruited through purposive sampling at a primary care clinic located in a disadvantaged area, and in-depth interviews were conducted. The data analysis indicated that the factors found to influence adherence were social and economic resources; causal attributions assigned to TB; the social, cultural, economic, disease-related, and psychological challenges faced as a consequence of having TB; quality of health care received; use of the traditional healing system; and the participants' HIV status. Factors found to be associated with nonadherence included poverty, HIV co-infection, stigma, unsupportive social and work environments, and a high prevalence of helplessness and hopelessness.
我们开展这项研究的目的是探究促成结核病患者坚持或不坚持直接观察下的短程治疗策略的因素。本研究采用了定性的现象学研究设计。通过立意抽样，在一个贫困地区的基层医疗诊所招募了15名年龄在18至57岁之间的男性和女性参与者，并进行了深入访谈。数据分析表明，发现影响坚持治疗的因素包括社会和经济资源；对结核病的因果归因；因患结核病而面临的社会、文化、经济、疾病相关和心理挑战；所接受的医疗保健质量；传统治疗体系的使用；以及参与者的艾滋病毒感染状况。发现与不坚持治疗相关的因素包括贫困、艾滋病毒合并感染、耻辱感、不支持的社会和工作环境，以及无助感和绝望感的高发生率。
