Serapelwane Maserapelo G, Davhana-Maselesele Mashudu, Masilo Gaboipolelwe M
Department of Nursing, North West University, Mafikeng Campus.
Curationis. 2016 Sep 27;39(1):e1-e9. doi: 10.4102/curationis.v39i1.1629.
Tuberculosis (TB) management remains a major challenge despite the implementation of Directly Observed Treatment Short-Course (DOTS). Some of the challenges include defaulting treatment, low TB cure rates and relapse after patients had been treated under DOTS.
This study explored and described experiences of patients having TB regarding the use of DOTS in Doctor Ruth Segomotsi Mompati District of North West Province, South Africa. The study describes and recommends support required by patients having TB who are using DOTS.
A qualitative, exploratory, descriptive and contextual design was used. The population consisted of all patients having TB under DOTS who had taken treatment for 2 months and more in one of the community health centres in Doctor Ruth Segomotsi Mompati District. Purposive sampling technique was applied to select participants receiving DOTS service. In-depth unstructured individual interviews were conducted, and data saturation occurred after having interviewed 15 participants. Ethical considerations were ensured throughout the study, and data were analysed using Tesch's method of coding and analysis.
Two themes emerged from data and these are discussed as concerns related to ineffective use of DOTS and lack of resources as contributory factor to ineffective use of DOTS. Among other categories, poor nurse-patient relationships and difficulties in accessing the community health centre emerged as consistent themes related to default and inconsistent use of DOTS.
Ineffective use of DOTS contributed to TB treatment default and low cure rate. Therefore, recommendations focused on strengthening effective use of DOTS for the management of TB.
尽管实施了直接观察短程治疗(DOTS),结核病管理仍然是一项重大挑战。其中一些挑战包括治疗中断、结核病治愈率低以及患者在接受DOTS治疗后复发。
本研究探讨并描述了南非西北省鲁思·塞戈莫齐·蒙帕蒂博士区结核病患者使用DOTS的经历。该研究描述并推荐了使用DOTS的结核病患者所需的支持。
采用定性、探索性、描述性和情境性设计。研究对象包括在鲁思·塞戈莫齐·蒙帕蒂博士区的一个社区卫生中心接受DOTS治疗且治疗时间达两个月及以上的所有结核病患者。采用目的抽样技术选择接受DOTS服务的参与者。进行了深入的非结构化个人访谈,在采访15名参与者后达到数据饱和。在整个研究过程中确保了伦理考量,并使用泰施编码和分析方法对数据进行分析。
数据中出现了两个主题,分别作为与DOTS使用无效相关的问题以及缺乏资源作为DOTS使用无效的促成因素进行讨论。在其他类别中,护士与患者关系不佳以及前往社区卫生中心困难成为与DOTS使用中断和不一致相关的一致主题。
DOTS使用无效导致了结核病治疗中断和治愈率低。因此,建议重点在于加强DOTS在结核病管理中的有效使用。