Born Lonny J, Wamulume Chibesa, Neroda Kim A, Quiterio Nicole, Giganti Mark J, Morris Mary, Bolton-Moore Carolyn, Baird Shelagh, Sinkamba Maggie, Topp Stephanie M, Reid Stewart E
Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of Washington, Seattle, Washington, USA.
Lusaka District Health Management Team , Lusaka, Zambia.
J Public Health Afr. 2012 Mar 7;3(1):e3. doi: 10.4081/jphia.2012.e3.
Rapid expansion of antiretroviral therapy (ART) and a shortage of health care workers (HCWs) required the implementation of a peer educator (PE) model as part of a task-shifting strategy in Lusaka District clinics. The purpose of this study was to evaluate patient and staff perceptions regarding whether the PE program: a) relieved the workload on professional HCWs; and b) delivered services of acceptable quality. Qualitative and quantitative data were gathered from five primary care clinics delivering ART in Lusaka, Zambia. Closed surveys were conducted with 148 patients receiving ART, 29 PEs, and 53 HCWs. Data was imported into Microsoft Excel to calculate descriptive statistics. Six focus group discussions and eight key informant (KI) interviews were conducted, recorded, transcribed, and coded to extract relevant data. Survey results demonstrated that 50 of 53 (96.1%) HCWs agreed PEs reduced the amount of counseling duties required of HCWs. HCWs felt that PEs performed as well as HCWs in counseling patients (48 of 53; 90.6%) and that having PEs conduct counseling enabled clinical staff to see more patients (44 of 53; 83%). A majority of patients (141 of 148; 95.2%) agreed or strongly agreed that PEs were knowledgeable about ART, and 89 of 144 (61.8%) expressed a high level of confidence with PEs performing counseling and related tasks. Focus group and KI interviews supported these findings. PEs helped ease the work burden of HCWs and provided effective counseling, education talks, and adherence support to patients in HIV care. Consideration should be given to formalizing their role in the public health sector.
抗逆转录病毒疗法（ART）的迅速推广以及医护人员（HCWs）的短缺，要求在卢萨卡地区诊所实施同伴教育者（PE）模式，作为任务转移策略的一部分。本研究的目的是评估患者和工作人员对PE项目的看法，即：a）是否减轻了专业医护人员的工作量；b）是否提供了质量可接受的服务。从赞比亚卢萨卡提供ART的五家初级保健诊所收集了定性和定量数据。对148名接受ART治疗的患者、29名同伴教育者和53名医护人员进行了封闭式调查。数据被导入Microsoft Excel以计算描述性统计数据。进行了六次焦点小组讨论和八次关键 informant（KI）访谈，进行了记录、转录和编码以提取相关数据。调查结果表明，53名医护人员中有50名（96.1%）同意同伴教育者减少了医护人员所需的咨询职责量。医护人员认为同伴教育者在为患者提供咨询方面与医护人员表现相当（53名中有48名；90.6%），并且让同伴教育者进行咨询使临床工作人员能够接待更多患者（53名中有44名；83%）。大多数患者（148名中有141名；95.2%）同意或强烈同意同伴教育者对ART有了解，144名中有89名（61.8%）对同伴教育者进行咨询和相关任务表示高度信任。焦点小组和关键 informant 访谈支持了这些发现。同伴教育者有助于减轻医护人员的工作负担，并为接受艾滋病毒护理的患者提供有效的咨询、教育讲座和依从性支持。应考虑在公共卫生部门将他们的角色正规化。
