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莫桑比克医护人员在实施结核病感染预防与控制措施方面面临的挑战。

Healthcare workers' challenges in the implementation of tuberculosis infection prevention and control measures in Mozambique.

作者信息

Brouwer Miranda, Coelho Eliana, Mosse Carla das Dores, Brondi Luciana, Winterton Laura, van Leth Frank

机构信息

Health Alliance International, Technical Assistance Unit, Maputo, Mozambique.

Ministry of Health, Maputo, Mozambique.

出版信息

PLoS One. 2014 Dec 15;9(12):e114364. doi: 10.1371/journal.pone.0114364. eCollection 2014.

Abstract

OBJECTIVE

Healthcare Workers (HCWs) have a higher frequency of TB exposure than the general population and have therefore an occupational TB risk that infection prevention and control (IPC) measures aim to reduce. HCWs are crucial in the implementation of these measures. The objective of the study was to investigate Mozambican HCWs' perceptions of their occupational TB risk and the measures they report using to reduce this risk. In addition, we explored the challenges HCWs encounter while using these TBIPC measures.

METHODS

Focus group discussion. Analysis according content method.

PARTICIPANTS

Four categories of HCWs: auxiliary workers, medical (doctors and clinical officers), nurses and TB program staff.

RESULTS

HCWs are aware of their occupational TB risk and use various measures to reduce their risk of infection. HCWs find it challenging to employ measures that minimize such risks and a lack of clear guidelines contributes to these challenges. HCWs' and patient behavior further complicate the use of TBIPC measures.

CONCLUSION

HCWs in Mozambique perceive a high occupational risk of TB infection. They report several challenges using measures to reduce this risk such as shortage of material, lack of clear guidelines, insufficient motivation and inadequate training. Robust training with motivational approaches, alongside supervision and support for HCWs could improve implementation of TBIPC measures. Healthcare management should address the areas for improvement that are beyond the individual HCW's control.

摘要

目的

医护人员接触结核病的频率高于普通人群,因此存在职业性结核病风险,感染预防与控制(IPC)措施旨在降低这种风险。医护人员在实施这些措施方面至关重要。本研究的目的是调查莫桑比克医护人员对其职业性结核病风险的认知以及他们报告用于降低这种风险的措施。此外,我们还探讨了医护人员在使用这些结核病感染预防与控制措施时遇到的挑战。

方法

焦点小组讨论。采用内容分析法进行分析。

参与者

四类医护人员:辅助人员、医疗人员(医生和临床干事)、护士和结核病项目工作人员。

结果

医护人员意识到其职业性结核病风险,并使用各种措施来降低感染风险。医护人员发现采取能将此类风险降至最低的措施具有挑战性,缺乏明确的指导方针加剧了这些挑战。医护人员和患者的行为使结核病感染预防与控制措施的使用进一步复杂化。

结论

莫桑比克的医护人员认为结核病感染的职业风险很高。他们报告在使用降低这种风险的措施时面临若干挑战,如物资短缺、缺乏明确的指导方针、动力不足和培训不够。对医护人员进行强有力的激励式培训,同时给予监督和支持,可改善结核病感染预防与控制措施的实施。医疗管理部门应解决超出个体医护人员控制范围的改进领域问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6fd7/4266607/2eb6847b908e/pone.0114364.g001.jpg

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