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南非管理医院中耐药结核病患者的戒烟干预障碍:医院工作人员的观点。

Perspectives of Hospital Staff on Barriers to Smoking Cessation Interventions among Drug-Resistant Tuberculosis Patients in a South African Management Hospital.

机构信息

Division of Public Health, Faculty of Health Sciences, University of Free State, Bloemfontein 9300, South Africa.

Department of Human Movement Science, Faculty of Science and Agriculture, University of Zululand, KwaDlangezwa 3886, South Africa.

出版信息

Int J Environ Res Public Health. 2024 Aug 28;21(9):1137. doi: 10.3390/ijerph21091137.

Abstract

Drug-resistant tuberculosis (DR-TB) remains a major cause of illness and death, with personal and non-addiction-related barriers. This study aimed to explore the perspectives of hospital staff on barriers to smoking cessation interventions (SCIs) for in-patients at a DR-TB management hospital in Durban, KwaZulu-Natal, South Africa. In-depth interviews were conducted with a purposive sample of eighteen hospital staff (HS), and the data were analyzed using NVivo 10. Three core themes were identified: patients' barriers (addiction to tobacco, relapse after improvement in health, and non-disclosure of smoking status to HS), staff personal barriers (poor knowledge of smoking's effect on treatment outcomes and smoking cessation aids), and institutional barriers (staff shortage, time constraints, lack of pharmacological smoking cessation aids, access to cigarettes around hospital premises, and SCIs not prioritized and not assigned to a specific category of HS). Training on SCIs for HS, assigning SCIs to specific HS, integrating SCIs within existing services, and banning access to cigarettes within the hospital premises are assumed to assist DR-TB patients in smoking cessation, improving their response to TB treatment and overall health outcomes.

摘要

耐多药结核病 (DR-TB) 仍然是导致疾病和死亡的主要原因,存在与个人和非成瘾相关的障碍。本研究旨在探讨德班夸祖鲁-纳塔尔省 DR-TB 管理医院住院患者戒烟干预 (SCI) 障碍的医院工作人员观点。对来自德班夸祖鲁-纳塔尔省 DR-TB 管理医院的 18 名医院工作人员 (HS) 进行了深入访谈,并使用 NVivo 10 对数据进行了分析。确定了三个核心主题:患者障碍 (对烟草的依赖、健康改善后复发以及不向 HS 透露吸烟状况)、工作人员个人障碍 (对吸烟对治疗结果和戒烟辅助工具影响的了解不足) 和机构障碍 (人员短缺、时间限制、缺乏药理学戒烟辅助工具、医院周围可以买到香烟以及 SCI 未被优先考虑且未分配给特定类别的 HS)。假设对 HS 进行 SCI 培训、将 SCI 分配给特定的 HS、将 SCI 纳入现有服务中以及禁止在医院内吸烟将有助于 DR-TB 患者戒烟,改善他们对结核病治疗的反应和整体健康结果。

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