Abt Associates Inc Ethiopia, Addis Ababa, Ethiopia.
College of Nursing, Midwifery & Healthcare, University of West London (Professor Extraordinarius, Development Studies, UNISA), London, United Kingdom.
PLoS One. 2023 Feb 2;18(2):e0270439. doi: 10.1371/journal.pone.0270439. eCollection 2023.
There is presently dearth of evidence in Ethiopia on patients' perception on quality of care given for multi-drug resistant tuberculosis (MDR-TB) and their satisfaction with the care and services they receive for the disease. Moreover, there is no evidence on the experiences and practices of caregivers for MDR-TB regarding the functionality of the programmatic management of MDR-TB at referral hospitals in Ethiopia. Thus, this study was conducted to address these gaps. Evidence in these areas would help to institute interventions that could enhance patient satisfaction and their adherence to the treatment given for MDR-TB.
This study employed an inductive phenomenological approach to investigate patients' perception of the quality of care given for MDR-TB, level of their satisfaction with the care they received for MDR-TB and the experiences and practices of caregivers for MDR-TB on the functionality of the programmatic management of MDR-TB at referral hospitals in Ethiopia. The data were analysed manually, and that helped to get more control over the data.
The majority of the patients were satisfied with the compassionate communication and clinical care they received at hospitals. However, as no doctor was dedicated exclusively for the MDR-TB centre of the hospitals, patients could not get timely medical attention during emergent medical conditions. Patients were dissatisfied with the poor communication and uncaring practice of caregivers found at treatment follow-up centres (TFCs). Patients perceived that socio-economic difficulties are both the cause of MDR-TB and it has also challenged their ability to cope-up with the disease and its treatment. Patients were dissatisfied with the poor quality and inadequate quantity of the socio-economic support they got from the programme. Despite the high MDR-TB and HIV/AIDS co-infection, services for both diseases were not available under one roof.
Socio-economic challenges, inadequate socio-economic support, absence of integrated care for MDR-TB and HIV/AIDS, and the uncaring practice of caregivers at treatment follow-up centres are found to negatively affect patients' perceived quality of care and their satisfaction with the care given for MDR-TB. Addressing these challenges is recommended to assist patients' coping ability with MDR-TB and its treatment.
目前，在埃塞俄比亚，缺乏关于患者对耐多药结核病（MDR-TB）治疗质量的看法以及对所接受的治疗和服务的满意度的证据。此外，对于 MDR-TB 护理人员在转诊医院实施 MDR-TB 方案管理方面的经验和做法，也没有相关证据。因此，开展这项研究旨在弥补这些空白。这些领域的证据将有助于实施干预措施，从而提高患者的满意度和对 MDR-TB 治疗的依从性。
本研究采用归纳现象学方法，调查患者对 MDR-TB 治疗质量的看法、对所接受的 MDR-TB 治疗的满意度以及 MDR-TB 护理人员在埃塞俄比亚转诊医院实施 MDR-TB 方案管理方面的经验和做法。通过手工分析数据，以便更好地控制数据。
大多数患者对在医院获得的富有同情心的沟通和临床护理感到满意。然而，由于医院没有专门为 MDR-TB 中心配备医生，因此患者在紧急医疗情况下无法获得及时的医疗关注。患者对在治疗随访中心（TFC）发现的沟通不畅和护理人员漠不关心的做法感到不满。患者认为社会经济困难既是 MDR-TB 的原因，也是他们应对疾病和治疗的能力的挑战。患者对从方案中获得的社会经济支持的质量差和数量不足感到不满。尽管 MDR-TB 和 HIV/AIDS 合并感染率很高，但这两种疾病的服务却不能在一个屋檐下提供。
社会经济挑战、社会经济支持不足、MDR-TB 和 HIV/AIDS 综合护理的缺失以及治疗随访中心护理人员的漠不关心的做法，对患者对治疗的感知质量和对 MDR-TB 治疗的满意度产生负面影响。建议应对这些挑战，以帮助患者应对 MDR-TB 及其治疗。
