Okeyo Ida L A, Dowse Ros
Faculty of Pharmacy, Rhodes University, South Africa; School of Public Health, University of Western Cape.
Afr J Prim Health Care Fam Med. 2018 May 24;10(1):e1-e7. doi: 10.4102/phcfm.v10i1.1687.
Community health workers (CHWs) have facilitated the move to decentralise tuberculosis (TB) management, but lack access to information appropriate both for personal use and in patient interaction and education.
To explore the impact of a pictorial-based TB booklet on reinforcing CHW knowledge and facilitating patient counselling.
This study was conducted in local primary health care clinics and the Hospice in Grahamstown, Eastern Cape Province in South Africa.
Quantitative and qualitative methods were used. A simple, 17-page, A5 booklet containing pictograms and simple text was designed in collaboration with CHWs who advised on preferred content. Its influence on knowledge was assessed in 31 CHWs using a 17-item questionnaire in a before-and-after study. The experiences of CHWs using the booklet were qualitatively explored using focus group discussions (FGD) and semi-structured interviews.
Overall knowledge increased significantly from 70.6% to 85.3% (p < 0.001) with 8 of 17 questions significantly better answered at follow-up. These addressed meaning of side effects and side effect advice for patients, cause and prevention of TB, action if a dose is forgotten, timing of dose in relation to food intake and the possibility that not all patients are cured.Community health workers reported using the booklet during patient interactions, commenting that it enhanced their confidence in their own TB-related knowledge, improved recall of information and reduced uncertainty. They appreciated the simplicity of the text and its userfriendliness because of the inclusion of pictograms. The booklet was perceived to be valuable as a tool for both patient education as well as improved communication with patients.
A simple, user-friendly TB booklet containing pictograms improved CHWknowledge and acted as a valuable tool in patient communication and education.
社区卫生工作者推动了结核病管理权力下放，但缺乏适用于个人使用以及患者互动和教育的信息。
探讨一本以图片为主的结核病手册对强化社区卫生工作者知识及促进患者咨询的影响。
本研究在南非东开普省格雷厄姆斯敦的当地初级卫生保健诊所及临终关怀医院开展。
采用定量和定性方法。与社区卫生工作者合作设计了一本简单的、17页的A5手册，其中包含象形图和简单文字，这些社区卫生工作者就首选内容提供了建议。在一项前后对照研究中，使用一份包含17个条目的问卷对31名社区卫生工作者评估了该手册对其知识的影响。通过焦点小组讨论和半结构化访谈，定性探索了社区卫生工作者使用该手册的体验。
总体知识水平从70.6%显著提高到85.3%（p<0.001），17个问题中有8个在随访时回答得明显更好。这些问题涉及副作用的含义及针对患者的副作用建议、结核病的病因和预防、忘记服药剂量时的处理、服药时间与食物摄入的关系以及并非所有患者都能治愈的可能性。社区卫生工作者报告在与患者互动时使用了该手册，并表示它增强了他们对自身结核病相关知识的信心，提高了信息的记忆力，减少了不确定性。他们赞赏文本的简洁性及其因包含象形图而具有的用户友好性。该手册被视为对患者教育以及改善与患者沟通均有价值的工具。
一本包含象形图的简单、用户友好的结核病手册提高了社区卫生工作者的知识水平，并成为患者沟通和教育的宝贵工具。
