Bedingfield N, Lashewicz B, Fisher D, King-Shier K
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Public Health Action. 2022 Jun 21;12(2):79-84. doi: 10.5588/pha.21.0081.
Adverse social determinants of health for people who are foreign-born are key drivers of TB-related disparity, particularly in low-incidence countries. Patients diagnosed with infectious TB and their family members must confront psychosocial challenges which may deepen pre-existing health inequities. However, little is known about patient and family members' perspective on these experiences.
To explore the infectious TB experience of patients and family members who are foreign-born.
This study formed one component of an ecologically framed, qualitative case study conducted in Calgary, AB, Canada. Data were collected using semi-structured interviews, chart review and field notes, and analysed thematically.
Eight families were represented in the sample comprised of six patients and 13 family members. Many patients and family members experienced high levels of fear and stress for months following the patient's diagnosis. Isolation was pervasive and multifaceted for both patients and family members. Intra-family support was critical for managing during early stages when the situation was most challenging. Support from outside the family was not prominent and attempts to obtain support from government programmes for paid sick leave and health insurance were mostly unsuccessful.
Patients and family members who are foreign-born experience multidimensional isolation as a result of TB stigma, language barriers and poor access to government programmes. TB programmes cannot meet family needs alone and systems of support should be created through collaboration with government institutions, and organisations serving ethnocultural communities.
出生在国外的人群面临的不良社会健康决定因素是结核病相关差异的关键驱动因素，尤其是在低发病率国家。被诊断患有传染性结核病的患者及其家庭成员必须面对心理社会挑战，这可能会加深原有的健康不平等。然而，对于患者及其家庭成员对这些经历的看法却知之甚少。
探讨出生在国外的患者及其家庭成员患传染性结核病的经历。
本研究是在加拿大艾伯塔省卡尔加里市进行的一项生态框架定性案例研究的一部分。通过半结构化访谈、病历审查和实地记录收集数据，并进行主题分析。
样本中有八个家庭，包括六名患者和十三名家庭成员。许多患者及其家庭成员在患者被诊断后的几个月里都经历了高度的恐惧和压力。隔离对患者和家庭成员来说普遍存在且具有多面性。在情况最具挑战性的早期阶段，家庭内部的支持对于应对至关重要。来自家庭外部的支持并不显著，并且从政府带薪病假和健康保险计划中获得支持的尝试大多没有成功。
出生在国外的患者及其家庭成员由于结核病污名、语言障碍以及难以获得政府计划的支持而经历多维度的隔离。结核病防治计划无法独自满足家庭需求，应通过与政府机构以及为民族文化社区服务的组织合作来建立支持体系。
