Department of Family Medicine and Primary Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
Afr J Prim Health Care Fam Med. 2023 Dec 22;15(1):e1-e16. doi: 10.4102/phcfm.v15i1.4255.
South Africa adopted the decentralised Drug Resistant Tuberculosis (DR-TB) care model in 2011 with a view of improving clinical outcomes.
This study explores the experiences and perceptions of patients and family members on the effectiveness of a decentralised community DR-TB care model in the Oliver Reginald Kaizana (OR) Tambo district municipality of the Eastern Cape, South Africa.
In this phenomenological qualitative research design, a semi-structured interview with prompts was conducted on 30 participants (15 patients and 15 family members). Framework approach to thematic content analysis was adopted for qualitative data analysis.
Four themes emerged from the patients' interviews: adequate knowledge of DR-TB and its transmission, fear of death and isolation, long travel distances, and exorbitant transportation cost. A 'ready' health system influenced the effectiveness of community DR-TB management, while interviews with family members yielded five themes: misconceptions about DR-TB, rapid diagnosis and adherence counselling, long travel distances, activated healthcare workers, and little role of traditional healer.
A perceived effectiveness of a community DR-TB care model in the OR Tambo district was demonstrated through the quality and comprehensiveness of care rendered by a 'ready' health system with activated health care workers (HCWs) who provided robust support and adequate knowledge of DR-TB and its treatment/side effects. However, misconceptions about DR-TB, long travel distances to treatment facilities, high cost of transportation and stigma remained challenging for most patients and family members.Contribution: This study provides insight into the lived experiences of a decentralised community DR-TB care model in the OR Tambo district in 2020.
南非于 2011 年采用了去中心化的耐药结核病（DR-TB）护理模式，旨在改善临床结果。
本研究探讨了患者和家属对南非东开普省奥利弗·雷金纳德·凯扎纳（OR）塔博地区分散式社区 DR-TB 护理模式有效性的经验和看法。
在这项现象学定性研究设计中，对 30 名参与者（15 名患者和 15 名家属）进行了带有提示的半结构化访谈。采用框架方法对主题内容进行了定性数据分析。
从患者访谈中得出了四个主题：对 DR-TB 及其传播有足够的了解、对死亡和孤立的恐惧、长途旅行和过高的交通成本。一个“就绪”的卫生系统影响了社区 DR-TB 管理的有效性，而对家属的访谈则产生了五个主题：对 DR-TB 的误解、快速诊断和坚持咨询、长途旅行、激活的医疗工作者和传统治疗师的作用很小。
通过一个“就绪”的卫生系统提供的高质量和全面的护理，以及激活的医疗保健工作者（HCWs）提供的对 DR-TB 及其治疗/副作用的充分了解和支持，体现了社区 DR-TB 护理模式的有效性。然而，对 DR-TB 的误解、到治疗设施的长途旅行、交通成本高和污名化仍然是大多数患者和家属面临的挑战。
本研究深入了解了 2020 年 OR 塔博地区去中心化社区 DR-TB 护理模式的实际情况。
