肯尼亚紧急护理中的 HIV 检测服务和 HIV 自我检测计划:一项针对医护人员的定性研究,旨在为改进服务提供方法提供信息。

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Adam R Aluisio, Scarlett J Bergam, John Kinuthia, John Wamutitu Maina, Sankei Pirirei, David Bukusi, Harriet Waweru, Rose Bosire, Josephine Chen, Daniel K Ojuka, David A Katz, Carey Farquhar, Michael J Mello, Kate M Guthrie
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引用次数: 0

摘要

在肯尼亚,未充分参与艾滋病毒检测服务(HTS)的人通常在急诊科(ED)接受治疗。医护人员提供的有关急诊室艾滋病毒检测服务的数据十分有限。为了了解急诊室艾滋病毒检测服务和艾滋病毒自我检测(HIVST)所面临的挑战和促进因素,我们完成了一项定性研究。研究通过六个医护人员焦点小组收集数据。对数据进行了归纳分析,并将其映射到能力-机会-动机行为模型中。49 名医护人员参加了焦点小组:其中包括 18 名护士、15 名艾滋病咨询师、10 名医生和 6 名管理人员。半边天面临的挑战包括员工负担、资源获取、系统整合不足以及疾病严重程度。半边天计划的促进因素包括对医护人员和患者的教育、服务协调以及具体的后续流程。艾滋病毒检测面临的挑战包括准确性问题、随访障碍和社会心理风险。艾滋病毒检测的促进因素包括患者自主性和保密性、资源利用率以及接触高危人群的能力。根据能力-机会-动机行为模式,在知识、决策过程、环境因素、社会影响和专业身份等领域采取干预措施,可支持加强综合提供 HIVST 的 ED-HTS 系统。本研究深入探讨了 ED-HTS 所面临的挑战和促进因素,并确定了实用的方法,以改善医护人员的行为和能力,为已经接触过医疗保健服务的人员提供服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HIV testing services and HIV self-testing programming within emergency care in Kenya: a qualitative study of healthcare personnel to inform enhanced service delivery approaches.

In Kenya, persons insufficiently engaged in HIV Testing Services (HTS) are often treated in emergency departments (ED). There are limited data from healthcare workers on ED-HTS. A qualitative study was completed to understand challenges and facilitators for ED-HTS and HIV self-testing (HIVST). Data were collected via six focus groups of healthcare workers. Data were inductively analyzed and mapped to the Capability-Opportunity-Motivation Behavioral Model. Focus groups were completed with 49 healthcare workers: 18 nurses, 15 HIV counselors, 10 physicians and 6 administrators. HTS challenges included staff burdens, resources access, deficiencies in systems integration and illness severity. HTS facilitators included education of healthcare workers and patients, services coordination, and specific follow-up processes. HIVST challenges included accuracy concerns, follow-up barriers and psychosocial risks. HIVST facilitators were patient autonomy and confidentiality, resource utilization and ability to reach higher-risk persons. Mapping to the Capability-Opportunity-Motivation Behavioral Model interventions within the domains of knowledge, decision processes, environmental aspects, social influences and professional identities could support enhanced ED-HTS with integrated HIVST delivery. This study provided insights into challenges and facilitators on ED-HTS and identifies pragmatic approaches to improve healthcare workers' behaviors and abilities to provide services to persons already in contact with healthcare.

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CiteScore
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