Department fo International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, USA.
Center for Global Non-Communicable Disease Research and Training, Johns Hopkins School of Medicine, 1830 E. Monument St., Baltimore, MD 21205, USA.
Health Educ Res. 2020 Aug 1;35(4):258-269. doi: 10.1093/her/cyaa016.
More than 90% of chronic obstructive pulmonary disease (COPD)-related deaths occur in low- and middle-income countries; however, few studies have examined the illness experiences of individuals living with and providing treatment for COPD in these settings. This study characterizes illness representations for COPD in Nakaseke, Uganda from the perspectives of health care providers, village health teams and community members (CMs) with COPD. We conducted 40 in-depth, semi-structured interviews (16 health care providers, 12 village health teams and 12 CMs, aged 25-80 years). Interviews were analyzed using inductive coding, and the Illness Representations Model guided our analysis. Stakeholder groups showed concordance in identifying causal mechanisms of COPD, but showed disagreement in reasons for care seeking behaviors and treatment preferences. CMs did not use a distinct label to differentiate COPD from other respiratory illnesses, and described both the physical and social consequences of COPD. Local representations can inform development of adapted educational and self-management tools for COPD.
超过 90%的慢性阻塞性肺疾病(COPD)相关死亡发生在中低收入国家;然而,很少有研究调查过生活在这些环境中并为 COPD 提供治疗的个人的疾病体验。本研究从医疗保健提供者、乡村卫生队和 COPD 社区成员(CM)的角度描述了乌干达 Nakaseke 的 COPD 疾病表现。我们进行了 40 次深入的半结构化访谈(16 名医疗保健提供者、12 个乡村卫生队和 12 名 COPD 社区成员,年龄在 25-80 岁之间)。访谈使用归纳编码进行分析,疾病表现模型指导我们的分析。利益相关者群体在确定 COPD 的因果机制方面表现出一致性,但在寻求护理行为和治疗偏好的原因方面存在分歧。CM 没有使用独特的标签将 COPD 与其他呼吸系统疾病区分开来,而是描述了 COPD 的身体和社会后果。当地的表现可以为 COPD 制定适应性教育和自我管理工具提供信息。