Department of Family Health, Hossana College of health sciences, Hossana, Ethiopia.
Department of Health informatics, Hossana College of Health Sciences, Hossana, Ethiopia.
BMC Health Serv Res. 2024 Apr 27;24(1):542. doi: 10.1186/s12913-024-10911-6.
Engagement of healthcare providers is one of the World Health Organization strategies devised for prevention and provision of patient centered care for multidrug resistant tuberculosis. The need for current research question rose because of the gaps in evidence on health professional's engagement and its factors in multidrug resistant tuberculosis service delivery as per the protocol in the prevention and management of multidrug resistant tuberculosis.
The purpose of this study was to explore the level of health care providers' engagement in multidrug resistant tuberculosis prevention and management and influencing factors in Hadiya Zone health facilities, Southern Ethiopia.
Descriptive phenomenological qualitative study design was employed between 02 May and 09 May, 2019. We conducted a key informant interview and focus group discussions using purposely selected healthcare experts working as directly observed treatment short course providers in multidrug resistant tuberculosis treatment initiation centers, program managers, and focal persons. Verbatim transcripts were translated to English and exported to open code 4.02 for line-by-line coding and categorization of meanings into same emergent themes. Thematic analysis was conducted based on predefined themes for multidrug resistant tuberculosis prevention and management and core findings under each theme were supported by domain summaries in our final interpretation of the results. To maintain the rigors, Lincoln and Guba's parallel quality criteria of trustworthiness was used particularly, credibility, dependability, transferability, confirmability and reflexivity.
Total of 26 service providers, program managers, and focal persons were participated through four focus group discussion and five key informant interviews. The study explored factors for engagement of health care providers in the prevention and management of multidrug resistant tuberculosis in five emergent themes such as patients' causes, perceived susceptibility, seeking support, professional incompetence and poor linkage of the health care facilities. Our findings also suggest that service providers require additional training, particularly in programmatic management of drug-resistant tuberculosis.
The study explored five emergent themes: patient's underlying causes, seeking support, perceived susceptibility, professionals' incompetence and health facilities poor linkage. Community awareness creation to avoid fear of discrimination through provision of support for those with multidrug resistant tuberculosis is expected from health care providers using social behavioral change communication strategies. Furthermore, program managers need to follow the recommendations of World Health Organization for engaging healthcare professionals in the prevention and management of multidrug resistant tuberculosis and cascade trainings in clinical programmatic management of the disease for healthcare professionals.
参与医疗保健提供者是世界卫生组织为预防和提供以患者为中心的耐多药结核病护理而制定的策略之一。根据预防和管理耐多药结核病的方案，需要当前研究问题，因为在耐多药结核病服务提供方面，卫生专业人员参与及其因素方面存在证据差距。
本研究旨在探讨哈迪亚地区卫生设施中卫生保健提供者参与耐多药结核病预防和管理的水平及其影响因素，埃塞俄比亚南部。
采用描述性现象学定性研究设计，于 2019 年 5 月 2 日至 9 日进行。我们对在耐多药结核病治疗启动中心直接观察治疗短期疗程提供者、方案管理人员和焦点人员工作的医疗保健专家进行了重点人物访谈和焦点小组讨论。逐字记录被翻译成英文，并导出到开放代码 4.02 进行逐行编码，并将含义分类为相同的新兴主题。根据耐多药结核病预防和管理的既定主题以及每个主题下的核心发现进行主题分析，并在最终解释结果时通过领域总结支持核心发现。为了保持严谨性，采用了林肯和古巴的可信度、可靠性、可转移性、可证实性和反身性等平行质量标准。
共有 26 名服务提供者、方案管理人员和焦点人员通过 4 个焦点小组讨论和 5 个重点人物访谈参与了研究。该研究探讨了卫生保健提供者在预防和管理耐多药结核病方面的参与因素，这些因素体现在五个新出现的主题中，包括患者的原因、感知易感性、寻求支持、专业能力不足和卫生保健设施联系不畅。我们的研究结果还表明，服务提供者需要额外的培训，特别是在耐药结核病的方案管理方面。
本研究探讨了五个新出现的主题：患者的潜在原因、寻求支持、感知易感性、专业人员的能力不足和卫生保健设施联系不畅。社区意识的创建，以避免通过为耐多药结核病患者提供支持而产生的歧视恐惧，预计将由卫生保健提供者使用社会行为改变沟通策略来实现。此外，方案管理人员需要遵循世界卫生组织的建议，让医疗保健专业人员参与耐多药结核病的预防和管理，并对医疗保健专业人员进行疾病临床方案管理的级联培训。
