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南非 COVID-19 大流行和政府封锁期间结核病幸存者的生活经历:定性分析。

The lived experiences of tuberculosis survivors during the COVID-19 pandemic and government lockdown in South Africa: a qualitative analysis.

机构信息

Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Department of Psychiatry, Boston Medical Center, Boston, MA, USA.

出版信息

BMC Public Health. 2023 Sep 5;23(1):1729. doi: 10.1186/s12889-023-16657-w.

Abstract

BACKGROUND

Tuberculosis (TB) is a major health concern in South Africa, where prior to COVID-19 it was associated with more deaths than any other infectious disease. The COVID-19 pandemic disrupted gains made in the global response to TB, having a serious impact on the most vulnerable. COVID-19 and TB are both severe respiratory infections, where infection with one places individuals at increased risk for negative health outcomes for the other. Even after completing TB treatment, TB survivors remain economically vulnerable and continue to be negatively affected by TB.

METHODS

This cross-sectional qualitative study, which was part of a larger longitudinal study in South Africa, explored how TB survivors' experienced the COVID-19 pandemic and government restrictions. Participants were identified through purposive sampling and were recruited and interviewed at a large public hospital in Gauteng. Data were analyzed thematically, using a constructivist research paradigm and both inductive and deductive codebook development.

RESULTS

Participants (n = 11) were adults (24-74 years of age; more than half male or foreign nationals) who had successfully completed treatment for pulmonary TB in the past two years. Participants were generally found to be physically, socioeconomically, and emotionally vulnerable, with the COVID-19 pandemic exacerbating or causing a recurrence of many of the same stressors they had faced with TB. Coping strategies during COVID similarly mirrored those used during TB diagnosis and treatment, including social support, financial resources, distraction, spirituality, and inner strength.

CONCLUSIONS

Implications and suggestions for future directions include fostering and maintaining a strong network of social support for TB survivors.

摘要

背景

结核病(TB)是南非的一个主要健康问题,在 COVID-19 之前,它导致的死亡人数超过任何其他传染病。COVID-19 大流行破坏了全球结核病应对工作取得的进展,对最弱势群体造成了严重影响。COVID-19 和结核病都是严重的呼吸道感染,其中一种感染会使个体感染另一种疾病的健康后果风险增加。即使完成了结核病治疗,结核病幸存者仍然经济脆弱,并继续受到结核病的负面影响。

方法

本横断面定性研究是南非一项更大的纵向研究的一部分,探讨了结核病幸存者如何经历 COVID-19 大流行和政府限制。参与者是通过目的抽样确定的,并在豪登省的一家大型公立医院招募和访谈。使用建构主义研究范式以及归纳和演绎编码本开发,对数据进行主题分析。

结果

参与者(n=11)为成年人(24-74 岁;超过一半为男性或外国公民),在过去两年中成功完成了肺结核治疗。参与者普遍身体、社会经济和情感脆弱,COVID-19 大流行加剧或导致他们在结核病期间面临的许多相同压力源再次出现。COVID 期间的应对策略也与结核病诊断和治疗期间使用的策略相似,包括社会支持、财务资源、分散注意力、精神寄托和内在力量。

结论

对未来方向的影响和建议包括为结核病幸存者培养和维持强大的社会支持网络。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/532e/10481461/3564f1c2d2a2/12889_2023_16657_Fig1_HTML.jpg

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