英国COVID-19大流行期间结核病感染成人的健康和疾病信念

Dialogues in health Pub Date : 2023-11-29 DOI:10.1016/j.dialog.2023.100162

Ayşenur Kılıç , Amy L. Clarke , Zoe Moon , Yohhei Hamada , Amy Hai Yan Chan , Ananna Rahman , Charlotte Layton , Chris J. Griffiths , Dominik Zenner , Ellen Powell , Heinke Kunst , Marc Lipman , Mike Mandelbaum , Padmasayee Papineni , Tessa Tattersall , Trinh Duong , Ibrahim Abubakar , Molebogeng X. Rangaka , Robert Horne

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引用次数: 0

摘要

2019冠状病毒病扰乱了英国的结核病预防规划，特别是结核病感染(TBI)护理。我们探讨COVID-19大流行的经历是否会影响患者对TBI及其治疗的看法。方法半结构化访谈作为改进TBI检测和治疗研究(RID-TB)计划的一部分，探讨TBI治疗的认知和实际障碍。在2020年8月至2021年4月期间，对19名被诊断为TBI的人进行了采访。录音记录和分析使用不断比较的方法，允许一个动态和迭代的主题探索。使用感知和实用性方法组织主题。一些参与者认为TBI是增加对COVID-19易感性的风险因素，而一些参与者认为TBI治疗可能会预防COVID-19或减轻其影响。在COVID-19限制期间对结核病服务的调整(例如，远程随访)和综合做法(例如，张贴药物)解决了脑外伤治疗的一些实际障碍。然而，我们确定了关于TBI和COVID-19的信念，这些信念可能成为参与TBI治疗的障碍，包括:将服务延误解释为TBI没有严重到需要治疗的迹象，以及对结核病诊所感染COVID-19的担忧。covid -19和TBI服务延迟影响了人们对TBI治疗依从性的看法和实际障碍。未能解决这些信念可能会导致人们对他们的治疗没有得到充分解决的担忧。利用远程咨询等服务调整来解决实际障碍，可能与COVID-19之外的问题相关。资助美国国立卫生研究院RID-TB项目(RP-PG-0217-20009)。

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Health and illness beliefs in adults with tuberculosis infection during the COVID-19 pandemic in the UK

Background

COVID-19 disrupted the TB prevention programme in the UK, especially for TB infection (TBI) care. We explore whether experience of the COVID-19 pandemic impacted on patients' perceptions of TBI and its treatment.

Methods

Semi-structured interviews were conducted as part of the Research to Improve Detection and Treatment of TBI (RID-TB) programme, exploring perceptual and practical barriers to TBI treatment. Nineteen people diagnosed with TBI were interviewed between August 2020 and April 2021. Recordings were transcribed and analysed using a constant comparative approach, allowing for a dynamic and iterative exploration of themes. Themes are organised using the Perceptions and Practicalities Approach.

Findings

Some participants perceived TBI as a risk factor for increased susceptibility to COVID-19, while some thought that treatment for TBI might protect against COVID-19 or mitigate its effects. Adaptations to TB services (e.g., remote follow-up) and integrated practices during the COVID-19 restrictions (e.g., medication being posted) addressed some practical barriers to TBI treatment. However, we identified beliefs about TBI and COVID-19 that are likely to act as barriers to engagement with TBI treatment, including: interpreting service delays as an indication of TBI not being serious enough for treatment and concerns about contracting COVID-19 in TB clinics.

Interpretation

COVID-19 and TBI service delays influence people's perceptions and practical barriers to TBI treatment adherence. Failure to address these beliefs may lead to people's concerns about their treatment not being fully addressed. Utilised service adaptations like remote consultations to address practical barriers may be relevant beyond COVID-19.