Tweya H, Feldacker C, Ben-Smith A, Weigel R, Boxshall M, Phiri S, Jahn A
International Union Against Tuberculosis and Lung Disease, Paris, France ; The Lighthouse Trust, Lilongwe, Malawi.
The Lighthouse Trust, Lilongwe, Malawi ; International Training and Education Center for Health, University of Washington, Seattle, Washington, USA.
Public Health Action. 2012 Dec 21;2(4):178-80. doi: 10.5588/pha.12.0018.
Malawi has a critical shortage of clinicians and nurses. This study evaluated whether health surveillance assistants (HSAs) could provide antiretroviral therapy (ART) efficiently and safely for stable patients. HSAs could identify patients with previously established criteria requiring clinical management, including ART initiates, children and patients on second-line treatment. HSAs were not capable of correctly identifying current complications, including potentially severe side effects and toxicities, and inappropriately referred stable patients to clinicians, reducing efficiency. While task shifting to HSAs appears promising, to be safe and efficient, additional clinical training is needed before potentially task shifting stable ART patient care to less skilled health care cadres.
马拉维临床医生和护士严重短缺。本研究评估了健康监测助理(HSA)能否为病情稳定的患者有效且安全地提供抗逆转录病毒疗法(ART)。健康监测助理能够识别符合先前既定标准、需要临床管理的患者,包括开始接受抗逆转录病毒治疗的患者、儿童以及接受二线治疗的患者。健康监测助理无法正确识别当前的并发症,包括潜在的严重副作用和毒性反应,并且不恰当地将病情稳定的患者转介给临床医生,降低了效率。虽然将任务转移给健康监测助理似乎前景乐观,但为了确保安全和高效,在可能将病情稳定的抗逆转录病毒治疗患者的护理任务转移给技能较低的医疗人员之前,还需要进行额外的临床培训。