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肯尼亚锡亚亚县亚拉分区男性自愿接受术后包皮环切术随访的动机与障碍

Motivators and barriers to uptake of post-operative voluntary medical male circumcision follow-up in Yala division, Siaya County, Kenya.

作者信息

Abunah Bonface, Onkoba Rueben, Nyagero Josephat, Muhula Samuel, Omondi Edward, Guyah Bernard, Omondi Gregory Barnabas

机构信息

Amref Health Africa in Kenya, Monitoring, Evaluation and Research, Kenya.

Maseno University, School of Public Health and Community Development, Kenya.

出版信息

Pan Afr Med J. 2016 Nov 26;25(Suppl 2):7. doi: 10.11604/pamj.supp.2016.25.2.9369. eCollection 2016.

Abstract

INTRODUCTION

Follow-up visits are recommended to all voluntary medical male circumcision clients (VMMC), however, adherence is variable. High lost-to-follow-up cases limit knowledge about clinical status of clients and adverse events. This study sought to establish Motivators and Barriers to the Uptake of VMMC post-operative follow-up services in Siaya County, Kenya.

METHODS

277 clients from five VMMC sites in Yala were recruited immediately post-operation to participate in a telephone interview between the 21st and 31st day post-surgery during which a semi-structured questionnaire was administered. Descriptive and inferential statistics was used to analyse quantitative information using SPSS while responses from open ended questions were grouped into themes, sieved out, coded and analyzed.

RESULTS

137(49.5%) of the 277 participants utilized the follow-up services. Health education (31.4%) and emergency reviews/adverse events (24.1%) were the main motivation for returning for follow-up while occupational and other engagements (29.7%) and presumption of healing (24.6%) were the main barriers. Type of facility attended (p=0.0173), satisfaction with the discharge process (p=0.0150) and residency in Yala (p<0.001) were statistically significant to the respondents' return for follow-up. 85(62.0%) of the participants returned on the 7th day, 9(6.6%) returned after 7 days, and 43(31.4%) returned before 7 days.

CONCLUSION

VMMC health education should include and emphasize the benefits of follow-up care to the clients and the providers should address the barriers to accessing follow-up services. Our results will inform the programme on areas identified to improve care for VMMC clients and reduce subsequent lost-to-follow-up cases.

摘要

引言

建议对所有接受自愿男性医学包皮环切术的客户(VMMC)进行随访,但依从性各不相同。高失访率限制了对客户临床状况和不良事件的了解。本研究旨在确定肯尼亚锡亚县VMMC术后随访服务接受情况的促进因素和障碍。

方法

从亚拉的五个VMMC站点招募了277名客户,术后立即参与了一项电话访谈,访谈在术后第21天至31天进行,期间使用了半结构化问卷。使用SPSS对定量信息进行描述性和推断性统计分析,同时将开放式问题的回答归纳为主题、筛选、编码和分析。

结果

277名参与者中有137名(49.5%)使用了随访服务。健康教育(31.4%)和紧急复查/不良事件(24.1%)是返回接受随访的主要动机,而工作和其他事务(29.7%)以及认为已痊愈(24.6%)是主要障碍。就诊机构类型(p=0.0173)、对出院过程的满意度(p=0.0150)以及在亚拉的居住情况(p<0.001)对受访者返回接受随访具有统计学意义。85名(62.0%)参与者在第7天返回,9名(6.6%)在7天后返回,43名(31.4%)在7天前返回。

结论

VMMC健康教育应纳入并强调随访护理对客户的益处,提供者应解决获取随访服务的障碍。我们的结果将为该项目提供信息,以确定改善VMMC客户护理和减少后续失访病例的领域。

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