1Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
2Department of Parasitology, College of Public Health, University of the Philippines Manila, Manila, The Philippines.
Am J Trop Med Hyg. 2021 Mar 22;104(5):1803-1810. doi: 10.4269/ajtmh.19-0507.
Palawan is the malaria-endemic province with the highest prevalence of malaria in the Philippines, and microscopists (community health workers) have been allowed to deliver early diagnosis and prompt treatment of malaria throughout the province since 1999. To improve the quality of care, the present mixed-methods study attempted to identify the factors associated with satisfaction of patients in Palawan with their microscopists by analyzing the patients' perspectives. First, a quantitative cross-sectional study was conducted among 48 ex-patients and their nine microscopists. Ex-patients were asked about their satisfaction with care, and microscopists were asked about their job satisfaction and ability. Structural equation modeling was conducted for data analysis. Second, a qualitative cross-sectional study was performed using narrative interviews. Data were analyzed using the NVivo 10 software program. As a result, both studies revealed high patient satisfaction with microscopists. The quantitative study showed that ex-patients' satisfaction with their microscopists was independently enhanced by two factors: high ability in malaria microscopic observation and low household wealth of the patients. Particularly, specific subpopulations (those with lower household wealth, relatively old people, and ethnic minorities) were more satisfied with the microscopists' care. The qualitative study strengthens this finding by showing that their microscopists offered prompt and precise diagnosis and effective treatment for free. In conclusion, microscopists were shown to have an important role in narrowing the disparities in malaria care in Palawan. It is important to maintain/enhance the ability of microscopists in malaria microscopy to satisfy their patients.
巴拉望是菲律宾疟疾流行程度最高的省份，自 1999 年以来，显微镜检查师（社区卫生工作者）一直被允许在全省范围内提供疟疾的早期诊断和及时治疗。为了提高医疗质量，本混合方法研究试图通过分析患者的观点来确定与患者对显微镜检查师满意度相关的因素。首先，在 48 名前患者及其 9 名显微镜检查师中进行了一项定量横断面研究。前患者被问及他们对护理的满意度，显微镜检查师被问及他们的工作满意度和能力。对数据进行结构方程建模分析。其次，使用叙事访谈进行了定性横断面研究。使用 NVivo 10 软件程序对数据进行分析。结果，两项研究均显示患者对显微镜检查师的满意度很高。定量研究表明，患者对显微镜检查师的满意度受两个因素的独立影响：疟疾显微镜观察能力高和患者家庭财富低。特别是，特定的亚人群（家庭财富较低、相对较老和少数民族）对显微镜检查师的护理更满意。定性研究通过表明他们的显微镜检查师提供免费的快速和准确的诊断和有效的治疗来加强这一发现。总之，显微镜检查师在缩小巴拉望疟疾护理差距方面发挥了重要作用。重要的是要保持/提高显微镜检查师在疟疾显微镜检查方面的能力，以满足他们的患者。
