Shayo Pendo Martha Joseph, Zewdie Elyana A, Byashalira Kenneth C, Chamba Nyasatu G, Mbelele Peter M, Bygbjerg Ib C, Lillebaek Troels, Christensen Dirk L, Heysell Scott K, Mpagama Stellah G
Public Health and Disease Surveillance, Kibong'oto Infectious Diseases Hospital, Mae Street, Lomakaa Road, Siha Kilimanjaro 25401, Tanzania, United Republic of Tanzania.
Pompano Lab, University of Virginia, Charlottesville, VA22908-1340, USA.
Open Nurs J. 2025;19. doi: 10.2174/0118744346356368241218080300. Epub 2025 Jan 31.
Managing tuberculosis (TB) patients with comorbidities requires a holistic and patient-centered approach. This study evaluated patient-centered care (PCC) experiences among TB patients with multimorbidity under the Adaptive Diseases Control Expert Program in Tanzania (ADEPT), with a focus on the TB/diabetes mellitus (DM) co-epidemic targeted by the program.
A quantitative cross-sectional study was conducted involving TB patients with associated comorbidities receiving care from nurses trained in PCC through the ADEPT program. Patients were assessed for their interpretation of how they received PCC across eight dimensions of care.
All 39 participants with TB had at least one comorbidity (100%). The most common multi-morbidities were TB/HIV (59.0%) and TB/DM (12.8%). Evaluation of needs, values, and preferences revealed that participants strongly felt healthcare workers considered these aspects (mean score = 4.53; scale 1 minimum- strongly disagree to 5 maximum- strongly agree). Subsequent analysis showed varying evaluations across dimensions. Patients reported robust endorsement for receiving care that involved family and friends, with mean scores of 4.04, and for access to care, with a mean score of 4.40. However, physical comfort, coordination, continuity of care, education and emotional support received comparatively lower rankings.
TB patients with multimorbidity under the ADEPT program experienced PCC. However, certain systemic issues such as physical spaces, coordination, transition of care, and information education did not meet patient's needs in their own assessment, indicating opportunities for further quality improvement. Scaling up the ADEPT program within healthcare systems is likely to enhance care provision for TB patients with multimorbidity through a patient-centered approach.
管理患有合并症的结核病（TB）患者需要采取全面且以患者为中心的方法。本研究评估了坦桑尼亚适应性疾病控制专家项目（ADEPT）下患有多种疾病的结核病患者的以患者为中心的护理（PCC）体验，重点关注该项目所针对的结核病/糖尿病（DM）合并流行情况。
开展了一项定量横断面研究，涉及患有相关合并症且通过ADEPT项目接受过PCC培训护士护理的结核病患者。评估患者对他们在八个护理维度中如何接受PCC的理解。
所有39名结核病参与者都至少有一种合并症（100%）。最常见的多种合并症是结核病/艾滋病毒（59.0%）和结核病/糖尿病（12.8%）。对需求、价值观和偏好的评估显示，参与者强烈感觉医护人员考虑了这些方面（平均得分 = 4.53；量表1最低分 - 强烈不同意到5最高分 - 强烈同意）。后续分析显示各维度的评估存在差异。患者对涉及家人和朋友的护理以及获得护理的认可度较高，平均得分分别为4.04和4.40。然而，身体舒适度、协调、护理连续性、教育和情感支持的排名相对较低。
ADEPT项目下患有多种疾病的结核病患者体验到了PCC。然而，某些系统性问题，如物理空间、协调、护理过渡和信息教育，在患者自身评估中未满足其需求，这表明有进一步提高质量的机会。在医疗系统内扩大ADEPT项目可能会通过以患者为中心的方法加强对患有多种疾病的结核病患者的护理。
