To develop a conceptual framework of adherence to treatment among Thai people living with tuberculosis, a grounded theory approach was used. A purposive sample of 20 Thai people living with tuberculosis, aged from 23 to 85 years, was interviewed. From the participants' perspective, a core category of social belonging was highlighted, with three categories of conditions connected: personal barriers, personal resilience, and social facilitation. Personal barriers encompassed fear of stigma, concealing the illness, and lack of knowledge and motivation to complete the treatment regime. Personal resilience encompassed positive thinking and self-awareness. Social facilitation encompassed the ease of access to health services, continuity in the health service's ability to choose a directly-observed therapy observer, and social support. This study contributes a deeper understanding of the perspective of Thai people living with tuberculosis with regards to adherence to tuberculosis treatment. It might improve how local healthcare workers provide tuberculosis care, and inspire them to tailor care to people living with tuberculosis in a local community to increase personal resilience and reduce stigma.
BACKGROUND: Tuberculosis (TB) is a major public health concern resulting in high rates of morbidity and mortality worldwide, particularly in low- and middle-income countries, despite treatment having been available for over 50 years. It remains a crucial health problem in Thailand. This study aimed to develop a program for building tuberculosis (TB) care competencies of village health volunteers (VHVs) and to examine its effects on the outcomes of care for TB patients. METHODS: The competency development program (CDP) was developed based on the principles of empowerment and community-based TB care. Forty VHVs in two villages of Khoglor sub-district, Trang, Thailand were recruited. Participants were classified into control and experimental groups equally (n=20) by using a matched pair technique. RESULTS: The results showed that the mean scores of TB knowledge, attitude towards TB care, and TB care skills in the experimental group at the baseline and post-intervention were significantly different (p < 0.05). The mean scores of TB knowledge, attitude towards TB care, and TB care skills in the experimental and control groups at the baseline were not different. However, the scores of these three competencies at the post-intervention were significantly higher in the experimental group, compared to the control group (p < .05). CONCLUSION: Per the findings of the study, healthcare professionals should incorporate the principles of empowerment and community-based TB care in TB training programs in order to enhance TB care competencies of community health volunteers.
BackgroundThailand is 18th out of the 22 countries with the highest tuberculosis (TB) burden. It will be a challenge for Thailand to achieve the UN Millennium Development target for TB, as well as the new WHO targets for eliminating TB by 2035. More knowledge and a new approach are needed to tackle the complex challenges of managing the DOT program in Thailand. Contextual factors strongly influence the local implementation of evidence in practice. Using the PARIHS model, the aim has been to explore district leaders’ perceptions of the management of the DOT program in Trang province, Thailand.MethodsA phenomenographic approach was used to explore the perceptions among district DOT program leaders in Trang province. We conducted semi-structured interviews with district leaders responsible for managing the DOT program in five districts. The analysis of the data transcriptions was done by grouping similarities and differences of perceptions, which were constructed in a hierarchical outcome space that shows a set of descriptive categories.ResultsThe first descriptive category revealed a common perception of the leaders’ duty and wish to comply with the NTP guidelines when managing and implementing the DOT program in their districts. More varied perceptions among the leaders concerned how to achieve successful treatment. Other perceptions concerned practical dilemmas, which included fear of infection, mutual distrust, and inadequate knowledge about TB. Further, the leaders perceived a need for improved management practices in implementing the TB guidelines.ConclusionUsing the PARIHS framework to gain a retrospective perspective on the district-level policy implementation of the DOT program and studying the leadership’s perceptions about applying the guidelines to practice, has brought new knowledge about management practices. Additional support and resources from the regional level are needed to manage the challenges.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.