Vladimir N Kuznetsov, Andrej M Grjibovski, Andrej O Mariandyshev, Eva Johansson, Gunnar A Bjune
{"title":"Two vicious circles contributing to a diagnostic delay for tuberculosis patients in Arkhangelsk.","authors":"Vladimir N Kuznetsov, Andrej M Grjibovski, Andrej O Mariandyshev, Eva Johansson, Gunnar A Bjune","doi":"10.3402/ehtj.v7.24909","DOIUrl":null,"url":null,"abstract":"<p><strong>Setting: </strong>Delay in tuberculosis (TB) diagnosis increases the infectious pool in the community and the risk of development of resistance of mycobacteria, which results in an increased number of deaths.</p><p><strong>Objective: </strong>To describe patients' and doctors' perceptions of diagnostic delay in TB patients in the Arkhangelsk region and to develop a substantive model to better understand the mechanisms of how these delays are linked to each other.</p><p><strong>Design: </strong>A grounded theory approach was used to study the phenomenon of diagnostic delay. Patients with TB diagnostic delay and doctors-phthisiatricians were interviewed.</p><p><strong>Results: </strong>A model named 'sickness trajectory in health-seeking behaviour among tuberculosis patients' was developed and included two core categories describing two vicious circles of diagnostic delay in patients with TB: 'limited awareness of the importance to contact the health system' and 'limited resources of the health system' and the categories: 'factors influencing health-seeking behaviour' and 'factors influencing the health system effectiveness'. Men were more likely to report patient delay, while women were more likely to report health system delay.</p><p><strong>Conclusions: </strong>To involve people in early medical examinations, it is necessary to increase alertness on TB among patients and to improve health systems in the districts.</p>","PeriodicalId":72898,"journal":{"name":"Emerging health threats journal","volume":" ","pages":"24909"},"PeriodicalIF":0.0000,"publicationDate":"2014-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3402/ehtj.v7.24909","citationCount":"19","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emerging health threats journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3402/ehtj.v7.24909","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2014/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 19
Abstract
Setting: Delay in tuberculosis (TB) diagnosis increases the infectious pool in the community and the risk of development of resistance of mycobacteria, which results in an increased number of deaths.
Objective: To describe patients' and doctors' perceptions of diagnostic delay in TB patients in the Arkhangelsk region and to develop a substantive model to better understand the mechanisms of how these delays are linked to each other.
Design: A grounded theory approach was used to study the phenomenon of diagnostic delay. Patients with TB diagnostic delay and doctors-phthisiatricians were interviewed.
Results: A model named 'sickness trajectory in health-seeking behaviour among tuberculosis patients' was developed and included two core categories describing two vicious circles of diagnostic delay in patients with TB: 'limited awareness of the importance to contact the health system' and 'limited resources of the health system' and the categories: 'factors influencing health-seeking behaviour' and 'factors influencing the health system effectiveness'. Men were more likely to report patient delay, while women were more likely to report health system delay.
Conclusions: To involve people in early medical examinations, it is necessary to increase alertness on TB among patients and to improve health systems in the districts.