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以患者为中心的结核病护理干预措施的范围综述:差距与机遇

A scoping review of patient-centred tuberculosis care interventions: Gaps and opportunities.

作者信息

Myburgh Hanlie, Baloyi Dzunisani, Loveday Marian, Meehan Sue-Ann, Osman Muhammad, Wademan Dillon, Hesseling Anneke, Hoddinott Graeme

机构信息

Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Amsterdam, The Netherlands.

出版信息

PLOS Glob Public Health. 2023 Feb 2;3(2):e0001357. doi: 10.1371/journal.pgph.0001357. eCollection 2023.

Abstract

Tuberculosis (TB) is a leading cause of death globally. In 2015, the World Health Organization hailed patient-centred care as the first of three pillars in the End TB strategy. Few examples of how to deliver patient-centred care in TB programmes exist in practice; TB control efforts have historically prioritised health systems structures and processes, with little consideration for the experiences of people affected by TB. We aimed to describe how patient-centred care interventions have been implemented for TB, highlighting gaps and opportunities. We conducted a scoping review of the published peer-reviewed research literature and grey literature on patient-centred TB care interventions between January 2005 and March 2020. We found limited information on implementing patient-centred care for TB programmes (13 research articles, 7 project reports, and 19 conference abstracts). Patient-centred TB care was implemented primarily as a means to improve adherence, reduce loss to follow-up, and improve treatment outcomes. Interventions focused on education and information for people affected by TB, and psychosocial, and socioeconomic support. Few patient-centred TB care interventions focused on screening, diagnosis, or treatment initiation. Patient-centred TB care has to go beyond programmatic improvements and requires recognition of the diverse needs of people affected by TB to provide holistic care in all aspects of TB prevention, care, and treatment.

摘要

结核病是全球主要死因之一。2015年,世界卫生组织将以患者为中心的照护誉为终结结核病战略三大支柱中的首要支柱。在实践中,几乎没有关于如何在结核病防治项目中提供以患者为中心照护的实例;历史上结核病防控工作一直将卫生系统的结构和流程作为优先事项,很少考虑结核病患者的体验。我们旨在描述针对结核病实施以患者为中心照护干预措施的方式,突出差距与机遇。我们对2005年1月至2020年3月间已发表的关于以患者为中心的结核病照护干预措施的同行评审研究文献和灰色文献进行了范围综述。我们发现关于在结核病防治项目中实施以患者为中心照护的信息有限(13篇研究文章、7份项目报告和19篇会议摘要)。以患者为中心的结核病照护主要作为提高依从性、减少失访以及改善治疗效果的一种手段来实施。干预措施侧重于为结核病患者提供教育和信息,以及心理社会和社会经济支持。很少有以患者为中心的结核病照护干预措施关注筛查、诊断或治疗启动环节。以患者为中心的结核病照护必须超越项目改进,需要认识到结核病患者的多样化需求,以便在结核病预防、照护和治疗的各个方面提供全面照护。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6146/10021744/0c799b65a08e/pgph.0001357.g001.jpg

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