Wilson John W, Ramos Julio Garay, Castillo Francisco, F Castellanos Evelyn, Escalante Patricio
Division of Infectious Diseases, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, United States.
Coordinador Nacional, Programa de Tuberculosis y Enfermedades Respiratorias, Ministerio de Salud El Salvador, República de El Salvador.
J Clin Tuberc Other Mycobact Dis. 2016 May 10;4:14-20. doi: 10.1016/j.jctube.2016.05.001. eCollection 2016 Aug.
Tublosis (TB) and the approaches to successful management are commonly misunderstood health topics among patients and family members within resource-limited settings. Such public misconceptions often result in delayed diagnoses of afflicted patients, suboptimal compliance with prescribed therapies and a negative community social stigma that hinders effective contact investigations.
To determine through an observational field pilot study if videography-based TB education program can be implemented in busy resource-limited outpatient TB clinic settings and improve both patient and family understanding of TB and its treatment, as well as, improve the efficiency of TB medical evaluations and corresponding contact investigations.
We produced and implemented a videography-based health educational pilot strategy in 14 TB clinics within El Salvador to supplement the discussions between health providers, patients and families. Field observations and impressions after the first year of implementation were recorded.
After viewing the video, patient impressions revealed greater understanding of TB including how it's transmitted and successfully treated, as well as, a more optimistic outlook of the diagnosis. Family members viewing the video displayed less fear and greater interest in TB and also exhibited more support for relatives undergoing evaluation or treatment. Salvadorian TB health providers reported improvements in patient compliance with treatment, contact investigations of suspected patients, delivery of sputum samples for testing, clinic time-efficiency spent with patients, and an observed reduction of negative family stigma of TB.
Our findings suggest that videography-based TB education can be successfully implemented in busy and resource-limited outpatient settings, and can provide a potentially efficient and low-cost effective strategy towards optimizing patient understanding, acceptance and compliance with TB treatment recommendations. This feasibility pilot study provides an opportunity within underresourced clinics for further evaluation regarding the favorable educational and sustainable impact of videography-based health education.
在资源有限的环境中,结核病(TB)及其成功管理方法是患者及其家庭成员普遍误解的健康话题。这种公众误解常常导致患病患者诊断延迟、对规定治疗的依从性欠佳,以及产生负面的社区社会污名,阻碍有效的接触者调查。
通过一项观察性现场试点研究,确定基于视频的结核病教育项目是否可以在繁忙的资源有限的门诊结核病诊所环境中实施,并提高患者及其家属对结核病及其治疗的理解,同时提高结核病医学评估和相应接触者调查的效率。
我们在萨尔瓦多的14家结核病诊所制定并实施了基于视频的健康教育试点策略,以补充医疗服务提供者、患者和家属之间的讨论。记录了实施第一年之后的现场观察和印象。
观看视频后,患者表示对结核病有了更深入的理解,包括其传播方式和成功治疗方法,并且对诊断结果更加乐观。观看视频的家庭成员对结核病的恐惧减少,兴趣增加,对接受评估或治疗的亲属也表现出更多支持。萨尔瓦多的结核病医疗服务提供者报告称,患者的治疗依从性、疑似患者的接触者调查、痰标本送检、与患者的门诊时间效率均有所改善,并且观察到结核病的家庭负面污名有所减少。
我们的研究结果表明,基于视频的结核病教育可以在繁忙且资源有限的门诊环境中成功实施,并可为优化患者对结核病治疗建议的理解、接受和依从性提供一种潜在高效且低成本的有效策略。这项可行性试点研究为资源不足的诊所提供了一个机会,以便进一步评估基于视频的健康教育的良好教育效果和可持续影响。