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林波波省一家地区医院结核病政策实施情况评估

An evaluation of the implementation of tuberculosis policies at a regional hospital in the Limpopo Province.

作者信息

Luhalima T R, Netshandama V O, Davhana-Maselesele M

机构信息

Department of Advanced Nursing, University of Venda.

出版信息

Curationis. 2008 Dec;31(4):31-8.

Abstract

The current rate of tuberculosis infections as a result of new infections, as well as reinfections of patients is of concern to the disease control and policy-making bodies of South Africa. Questions regarding the effectiveness of tuberculosis policies and programmes emerge all the time. This study intended to evaluate the extent to which tuberculosis policies are implemented in a regional hospital in the Vhembe district in the Limpopo Province. The study was conducted using a qualitative, descriptive, exploratory and contextual design. A purposive sample of professional nurses who work in medical wards was selected, and voluntary participation was ensured. Data was collected through individual interviews, which were audiotaped and then transcribed verbatim. The researcher used an observation checklist to find out which policies were available and accessible that dealt with the management of tuberculosis. Findings revealed that tuberculosis policies were not available in the medical wards and not accessible on shelves. Participants expressed lack of knowledge about the existing tuberculosis policies. Lack of information was attributed to insufficient policy information dissemination associated with lack of in-service training and reporting mechanisms after workshops. Shortage of treatment was also indicated as a deterrent to effective policy implementation. The conclusion was reached, based on the findings of the research, that unless there was ongoing monitoring and evaluation of tuberculosis policies at local clinic level, including hospital level, tuberculosis policies would continue to be talked about at a broader (global) level without the focus on implementation at grassroots level. Strategies should be put in place to encourage professional nurses' ownership of policies.

摘要

新感染以及患者再感染导致的当前结核病感染率,是南非疾病控制和决策机构所关注的问题。关于结核病政策和项目有效性的问题一直层出不穷。本研究旨在评估林波波省韦姆贝区一家地区医院实施结核病政策的程度。该研究采用了定性、描述性、探索性和情境性设计。选取了在医疗病房工作的专业护士作为有目的的样本,并确保其自愿参与。通过个人访谈收集数据,访谈进行了录音,随后逐字转录。研究人员使用观察清单来查明哪些关于结核病管理的政策是可得且可获取的。研究结果显示,医疗病房没有结核病政策,书架上也无法获取相关政策。参与者表示对现有的结核病政策缺乏了解。信息匮乏归因于与在职培训不足以及研讨会后缺乏报告机制相关的政策信息传播不充分。治疗短缺也被指出是有效政策实施的阻碍。基于研究结果得出的结论是,除非在包括医院层面在内的当地诊所层面持续监测和评估结核病政策,否则结核病政策将继续在更广泛的(全球)层面被讨论,而不会专注于基层层面的实施。应制定策略以鼓励专业护士对政策的自主掌握。

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