转变护理实践以优化坦桑尼亚乞力马扎罗山地区结核病和相关合并症患者的护理。

Q3 Nursing
Open Nursing Journal Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI:10.2174/0118744346356368241218080300
Pendo Martha Joseph Shayo, Elyana A Zewdie, Kenneth C Byashalira, Nyasatu G Chamba, Peter M Mbelele, Ib C Bygbjerg, Troels Lillebaek, Dirk L Christensen, Scott K Heysell, Stellah G Mpagama
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引用次数: 0

摘要

背景:管理伴有合并症的结核病(TB)患者需要一种以患者为中心的整体方法。本研究评估了坦桑尼亚适应性疾病控制专家项目(ADEPT)下多病结核病患者以患者为中心的护理(PCC)经验,重点关注该项目针对的结核病/糖尿病(DM)共流行。方法:一项定量的横断面研究涉及有相关合并症的结核病患者,这些患者通过ADEPT项目接受过PCC培训的护士的护理。评估患者对他们如何在八个护理维度上接受PCC的解释。结果:所有39名结核病患者至少有一种合并症(100%)。最常见的多重疾病是结核/艾滋病(59.0%)和结核/糖尿病(12.8%)。对需求、价值观和偏好的评估显示,参与者强烈认为医护人员考虑了这些方面(平均得分= 4.53;等级1最小值-强烈不同意至5最大值-强烈同意)。随后的分析显示了不同维度的评估。患者报告对接受涉及家人和朋友的护理的强烈支持,平均得分为4.04,对获得护理的平均得分为4.40。然而,身体舒适度、协调性、护理连续性、教育和情感支持的排名相对较低。结论:在ADEPT项目下的多病结核病患者经历了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等,在患者自己的评估中没有满足患者的需求,这表明了进一步提高质量的机会。通过以患者为中心的方法,在卫生保健系统内扩大ADEPT项目可能会加强对多病结核病患者的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Transforming Nursing Practice to Optimize Care of Patients with Tuberculosis and Associated Comorbidities in the Kilimanjaro Region, Tanzania.

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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来源期刊
Open Nursing Journal
Open Nursing Journal Nursing-Nursing (all)
CiteScore
1.10
自引率
0.00%
发文量
37
期刊介绍: The Open Nursing Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, letters and guest edited thematic issues in all areas of nursing. The Open Nursing Journal, a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on publishing quality papers rapidly and freely available to researchers worldwide. We welcome papers related to nursing and midwifery, with specific relevance to health care practice, policy and research. We publish under the following themes: -Nursing and Midwifery practice -Education -Research methodology -Evidence based practice -New role in practice -Systematic reviews -Case studies -Ethical and professional issues -Management in health care -Sustainability in health and health care provision All authors should make clear how the implications of their paper for nursing, midwifery and health care practice. They should also clearly identify the ‘take home message’ from their paper.
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