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美墨边境的墨西哥裔美国人的结核病治疗。

Tuberculosis treatment for Mexican Americans living on the U.S.-Mexico border.

机构信息

Alpha Epsilon, Post-Doctoral Fellow, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA.

出版信息

J Nurs Scholarsh. 2014 Jul;46(4):253-62. doi: 10.1111/jnu.12071. Epub 2014 Mar 5.

Abstract

PURPOSE

This study produced a rich description of the lived experiences of tuberculosis (TB) treatment among Mexican Americans living in the Lower Rio Grande Valley (LRGV) of Texas.

DESIGN

This qualitative study used phenomenological methodology, guided by Merleau-Ponty's philosophical framework, particularly his theories on mind-body influence, fabric of relationships, importance of culture, and equilibrium. A purposive sample was recruited through TB clinics in four south Texas border counties: Hidalgo, Cameron, Starr, and Willacy, which make up the LRGV. Interviews from 18 participants-5 women and 13 men-were conducted in the participant's preferred language. Interviews were analyzed for common themes as described by Cohen Kahn and Steeves.

FINDINGS

The majority of interviews were conducted in Spanish. Five themes were discovered: (a) day-to-day life during Directly Observed Therapy treatment, (b) signs and symptoms, (c) familismo, (d) living on the border, and (e) stigma.

CONCLUSIONS

TB treatment can create a high level of patient burden. The participants in TB treatment in the LRGV on the Texas-Mexico border reported a high level of stigma. Due to this stigma, patients struggled to find a balance between exposure to stigma and the support from family that buoyed them through treatment.

CLINICAL RELEVANCE

The findings support the importance of addressing stigma and the resulting sense of isolation in patients being treated for TB, perhaps through bolstering support from family and healthcare providers, which is relevant for public health professionals working in regions with high rates of TB.

摘要

目的

本研究对生活在德克萨斯州下里奥格兰德河谷(LRGV)的墨西哥裔美国人的肺结核(TB)治疗体验进行了详细描述。

设计

这项定性研究采用了现象学方法,以梅洛-庞蒂的哲学框架为指导,特别是他关于身心影响、关系结构、文化重要性和平衡的理论。通过德克萨斯州南部四个边境县(包括伊达尔戈、卡梅伦、斯塔和韦拉克鲁斯)的 TB 诊所,采用目的性抽样招募了参与者。从 18 名参与者(5 名女性和 13 名男性)中进行了访谈,访谈以参与者首选的语言进行。根据科恩·卡恩和斯蒂夫斯的描述,对访谈进行了主题分析。

发现

大多数访谈都是用西班牙语进行的。发现了五个主题:(a)直接观察治疗期间的日常生活,(b)症状,(c)家庭主义,(d)生活在边境,(e)耻辱感。

结论

TB 治疗会给患者带来很大的负担。在德克萨斯州-墨西哥边境的 LRGV 接受 TB 治疗的参与者报告了很高的耻辱感。由于这种耻辱感,患者在面对耻辱和来自家庭的支持之间努力寻找平衡,而这种支持帮助他们完成了治疗。

临床意义

这些发现支持在治疗 TB 的患者中解决耻辱感和由此产生的孤立感的重要性,也许可以通过增强来自家庭和医疗保健提供者的支持来实现,这对于在 TB 发病率较高的地区工作的公共卫生专业人员具有重要意义。

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