社区卫生工作者在艾滋病毒护理中的作用：坦桑尼亚利益攸关方观点的定性研究。

The Role of Community Health Workers in HIV Care Engagement: A Qualitative Study of Stakeholder Perspectives in Tanzania.

机构信息

Brandon A. Knettel, PhD, is an Assistant Professor, Duke University School of Nursing and Duke Global Health Institute, Durham, North Carolina, USA. Kimberly M. Fernandez, BA, BS, is a Master of Physiology Graduate, North Carolina State University, Raleigh, North Carolina, USA. Lisa Wanda, BS, is a Research Assistant, Kilimanjaro Clinical Research Institute, Moshi, Tanzania. Ismail Amiri, BA, is a Research Assistant, Kilimanjaro Clinical Research Institute, Moshi, Tanzania. Clair Cassiello-Robbins, PhD, is a Clinical Associate, Center for Misophonia and Emotion Regulation, Department of Psychiatry, Duke University Medical Center, Durham, North Carolina, USA. Melissa H. Watt, PhD, is an Associate Professor, Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA. Blandina T. Mmbaga, MD, MMed, PhD, is a Pediatrician at Kilimanjaro Christian Medical Centre, Director of Research and Consultancy at Kilimanjaro Christian Medical University College, Director of the Kilimanjaro Clinical Research Institute, and Adjunct Associate Professor at Duke Global Health Institute, Durham, North Carolina, USA. Michael V. Relf, PhD, RN, AACRN, ANEF, FAAN, is the Editor-in-Chief of JANAC and the Associate Dean for Global and Community Health Affairs, Duke University School of Nursing and Associate Professor, Duke Global Health Institute, Durham, North Carolina, USA.

出版信息

J Assoc Nurses AIDS Care. 2021;32(6):682-692. doi: 10.1097/JNC.0000000000000267.

DOI:10.1097/JNC.0000000000000267

PMID:33908407

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8548405/

Abstract

Suboptimal retention in HIV care is a major driver of the global epidemic, including in sub-Saharan Africa. In Tanzania, the national Community-Based HIV Services program integrates volunteer community health workers (CHWs) to support patient care engagement and reduce the burden placed on HIV clinic nurses; however, few studies have assessed the value of CHWs supporting HIV care. Qualitative interviews were conducted with 48 administrators, nurses, CHWs, and patients to explore strengths and limitations of the Community-Based HIV Services program. Stakeholders believed CHWs are uniquely positioned to establish trust and provide patient support. Patients who had frequent contact with CHWs described them as valued sources of education and encouragement, but fewer than half of the patients interviewed had ever met with a CHW. Clinic nurses described feeling disconnected from CHWs, and stakeholders highlighted the need for financial, logistical, and educational support to rejuvenate the program and effectively address care engagement challenges.

摘要

艾滋病毒护理中的保留率不理想是全球艾滋病流行的主要驱动因素，包括撒哈拉以南非洲地区。在坦桑尼亚，国家社区为基础的艾滋病毒服务方案整合了志愿社区卫生工作者（CHWs），以支持病人护理的参与，减轻艾滋病毒诊所护士的负担；然而，很少有研究评估 CHWs 支持艾滋病毒护理的价值。对 48 名行政人员、护士、CHWs 和病人进行了定性访谈，以探讨社区为基础的艾滋病毒服务方案的优势和局限性。利益攸关方认为，CHWs 具有独特的优势，可以建立信任和为病人提供支持。与 CHWs 有频繁接触的病人将他们描述为有价值的教育和鼓励来源，但接受采访的病人中不到一半曾见过 CHW。诊所护士表示感到与 CHWs 脱节，利益攸关方强调需要财政、后勤和教育支持，以振兴该方案，并有效地解决护理参与的挑战。