Section Global Health, Institute of Hygiene and Public Health, University of Bonn, Bonn, Germany
School of Women and Gender Studies, Makerere University, Kampala, Uganda.
BMJ Open. 2023 Jul 31;13(7):e070479. doi: 10.1136/bmjopen-2022-070479.
This study was conducted to assess acceptability of surgical care in Eastern Uganda and enable better allocation of resources, and to guide health policy towards increased surgical care seeking.
This qualitative study used semistructured in-depth interviews that were transcribed and analysed by coding according to grounded theory.
The study was set in Eastern Uganda in the districts of Jinja, Mayuge, Kamuli, Iganga, Luuka, Buikwe and Buvuma.
Interviews were conducted with 32 past surgical patients, 16 community members who had not undergone surgery, 17 healthcare professionals involved in surgical treatment and 7 district health officers or their deputies.
The five intersecting categories that emerged were health literacy, perceptions, risks and fears, search for alternatives, care/treatment and trust in healthcare workers. It was also demonstrated that considering the user and provider side at the same time is very useful for a more extensive understanding of surgical care-seeking behaviour and the impact of user-provider interactions or lack thereof.
While affordability and accessibility are well defined and therefore easier to assess, acceptability is a much less quantifiable concept. This study breaks it down into tangible concepts in the form of five categories, which provide guidance for future interventions targeting acceptability of surgical care. We also demonstrated that multiple perspectives are beneficial to understanding the multifactorial nature of healthcare seeking and provision.
本研究旨在评估乌干达东部地区外科护理的可接受性，以便更好地分配资源，并为增加外科护理寻求指导卫生政策。
本定性研究采用半结构式深入访谈，根据扎根理论进行编码转录和分析。
研究在乌干达东部的金贾、马尤盖、卡穆利、伊甘加、卢卡、布维武马和布武马县进行。
访谈对象包括 32 名过去接受过手术的患者、16 名未接受过手术的社区成员、17 名参与外科治疗的医疗保健专业人员以及 7 名区卫生官员或其副手。
出现了五个相互交叉的类别，分别是健康素养、认知、风险和恐惧、寻求替代方案、护理/治疗以及对医疗保健工作者的信任。同时也表明，同时考虑患者和提供者的角度对于更广泛地理解手术寻求行为以及用户-提供者互动或缺乏互动的影响非常有用。
虽然可负担性和可及性定义明确，因此更容易评估，但可接受性是一个难以量化的概念。本研究将其细分为五个类别的有形概念，为未来针对手术护理可接受性的干预措施提供指导。我们还表明，多视角有助于理解医疗保健寻求和提供的多因素性质。
