在乌干达农村，护士和其他医疗保健提供者在提供隐球菌性脑膜炎护理方面面临着缺乏教育、知识和供应品的障碍：一项混合方法研究。

Lack of education, knowledge, and supplies are barriers to cryptococcal meningitis care among nurses and other healthcare providers in rural Uganda: A mixed methods study.

机构信息

Center for Global Health and Social Responsibility, University of Minnesota, Minneapolis, MN, USA; Department of Medicine, Infectious Diseases, University of Rochester, Rochester, NY, USA.

Department of Internal Medicine, Lira Regional Referral Hospital, Faculty of Health Sciences, Lira University, Lira, Uganda.

出版信息

Nurse Educ Today. 2023 Sep;128:105873. doi: 10.1016/j.nedt.2023.105873. Epub 2023 Jun 14.

DOI:10.1016/j.nedt.2023.105873

PMID:37390523

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11138314/

Abstract

BACKGROUND

Cryptococcal meningitis (CM) is one of the deadliest opportunistic infections related to HIV/AIDS. A research gap exists surrounding the barriers to CM diagnosis, treatment delivery, and care from the healthcare provider's perspective.

OBJECTIVES

The purpose of this study was to elucidate provider's behaviors, to identify barriers and facilitators to diagnose and treat CM, and to assess their knowledge of CM, cryptococcal screening, and treatment.

DESIGN, SETTING, AND PARTICIPANTS: A convergent mixed-methods study among twenty healthcare providers who provided CM patient referrals to Lira Regional Referral Hospital in Lira, Uganda.

METHODS

Surveys and interviews were conducted to obtain information from healthcare providers who referred CM patients to Lira Regional Referral Hospital from 2017 to 2019. Questions related to provider education, knowledge, barriers to CM care, and patient education were inquired to understand the providers' perspectives.

RESULTS

Nurses had the least amount of CM knowledge with half knowing the cause of CM. Approximately half the participants knew about CM transmission, but only 15 % knew the duration of CM maintenance therapy. Most participants (74 %) last had education regarding CM during didactic training. In addition, 25 % disclosed they never educate patients due to time constraints (30 %) and lack of knowledge (30 %). Nurses (75 %) were least likely to provide patient education. Most participants acknowledged their lack of CM knowledge and attributed it to a lack of education and perceived inexperience with CM.

CONCLUSIONS

Providers' gaps in knowledge due to the lack of education and experience contributes to decreased patient education, and the lack of access to appropriate supplies affects their provision for CM diagnosis, treatment, and care. These results can guide evidence-based interventions to improve health providers' knowledge. Recommendations for standardized CM education should be developed for both providers and patients in collaboration with professional boards and the Uganda Ministry of Health.

摘要

背景

隐球菌性脑膜炎（CM）是与 HIV/AIDS 相关的最致命的机会性感染之一。从医疗保健提供者的角度来看，CM 的诊断、治疗提供和护理方面存在研究空白。

目的

本研究旨在阐明提供者的行为，确定诊断和治疗 CM 的障碍和促进因素，并评估他们对 CM、隐球菌筛查和治疗的了解。

设计、地点和参与者：在乌干达利拉地区转诊医院，对 20 名提供 CM 患者转诊的医疗保健提供者进行了一项汇聚混合方法研究。

方法

对 2017 年至 2019 年向利拉地区转诊医院转诊 CM 患者的医疗保健提供者进行了调查和访谈。询问了与提供者教育、知识、CM 护理障碍以及患者教育相关的问题，以了解提供者的观点。

结果

护士对 CM 的了解最少，其中一半人知道 CM 的病因。约有一半的参与者了解 CM 的传播途径，但只有 15%的人知道 CM 维持治疗的持续时间。大多数参与者（74%）最后一次接受 CM 相关教育是在专题培训期间。此外，由于时间限制（30%）和缺乏知识（30%），25%的参与者表示他们从不向患者进行教育。护士（75%）最不可能向患者提供教育。大多数参与者承认他们缺乏 CM 知识，并将其归因于缺乏教育和对 CM 的经验不足。