Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients ...Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients belonging to a low-income district within Manguinhos catchment area. Narrative studies are able to unfold features concerning patient adherence and co-occurrence of depressive symptoms. Methods: Twenty-three patients under treatment were interviewed using McGill Illness Narrative Interview (MINI-McGILL), besides depression screening with “Self-Report Questionnaire-20” (SRQ-20) and “Beck Depression Inventory” (BDI). Results: Explanatory models disregarded airborne microorganism contagion, known but not considered relevant while bohemian or deviant lifestyle was rather perceived as a causal model. Patients mentioned contiguous events suggesting pneumonia or influenza misdiagnosis before final tuberculosis diagnosis (testing or suspicion). Therapeutic pathways were erratic, suggesting low literacy level and postponed or inadequate diagnosis accuracy. Emergency units or private services usually stood for primary care units considered first choice by planners. Expressions such as “dreadful/shameful disease” or “very heavy illness” acknowledged stigma. Research data detected the importance of social network role, highlighting the family through financial and affective support. Hopelessness and depression were closely related to illness suffering and adversities. The percentage of patients for positive common mental disorder and depression approaches 30%. Conclusion: Tuberculosis remains a stigmatizing disease. Building effective health services networks, comprising treatment facilities, community and family resources are very important to improve medication adherence. Effective tuberculosis management through health teams training seems necessary. Incorporating simple screening instruments for depression assessment might promote well-being and patient adherence.展开更多
Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers...Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.展开更多
目的:引进简明幸福与生活质量满意度问卷(Quality of Life Enjoyment and Satisfaction Ques-tionnaire,Short Form,Q-LES-Q-SF),评估其在中国精神障碍患者中的信效度和适用性。方法:在山东省精神卫生中心2007年7月-2008年1月的门诊和...目的:引进简明幸福与生活质量满意度问卷(Quality of Life Enjoyment and Satisfaction Ques-tionnaire,Short Form,Q-LES-Q-SF),评估其在中国精神障碍患者中的信效度和适用性。方法:在山东省精神卫生中心2007年7月-2008年1月的门诊和住院患者中,按照就诊或住院的先后顺序,选取385例符合《ICD-10精神与行为障碍分类》诊断标准的精神分裂症(n=193)和心境障碍患者(n=192);按1∶2的比例选取与其相匹配的健康对照者196例。对所有对象进行Q-LES-Q-SF初次测评,30天后进行重测,对原始测评结果进行信度分析。以世界卫生组织生活质量量表(World Health Organization Quality of Life,WHO-QOL-100)为效标变量评价患者和健康对照者效标效度并进行区分效度分析。结果:信度分析显示量表的Cronbacnα系数为0.920,重测信度为0.785。总量表评分与WHOQOL-100总分及6个领域和24个方面均具有较高的相关性(心境障碍,r=0.22～0.71;精神分裂症,r=0.24～0.70;健康对照,r=0.17～0.73;Ps<0.01)。精神分裂症组和心境障碍组患者的幸福与生活质量满意度总分及各条目分均低于健康对照组[如总分,(46.42±8.36)vs.(54.34±8.11),(46.20±10.12)vs.(54.34±8.11),Ps<0.01]。结论:简明幸福与生活质量满意度问卷在中国精神障碍患者中有较好的信效度,适用于精神障碍患者生活质量的量化评估。展开更多
文摘Introduction: Tuberculosis is a global health problem. Improving medication adherence is an important attribute concerning the outcome of tuberculosis treatment. This study investigates illness experience of patients belonging to a low-income district within Manguinhos catchment area. Narrative studies are able to unfold features concerning patient adherence and co-occurrence of depressive symptoms. Methods: Twenty-three patients under treatment were interviewed using McGill Illness Narrative Interview (MINI-McGILL), besides depression screening with “Self-Report Questionnaire-20” (SRQ-20) and “Beck Depression Inventory” (BDI). Results: Explanatory models disregarded airborne microorganism contagion, known but not considered relevant while bohemian or deviant lifestyle was rather perceived as a causal model. Patients mentioned contiguous events suggesting pneumonia or influenza misdiagnosis before final tuberculosis diagnosis (testing or suspicion). Therapeutic pathways were erratic, suggesting low literacy level and postponed or inadequate diagnosis accuracy. Emergency units or private services usually stood for primary care units considered first choice by planners. Expressions such as “dreadful/shameful disease” or “very heavy illness” acknowledged stigma. Research data detected the importance of social network role, highlighting the family through financial and affective support. Hopelessness and depression were closely related to illness suffering and adversities. The percentage of patients for positive common mental disorder and depression approaches 30%. Conclusion: Tuberculosis remains a stigmatizing disease. Building effective health services networks, comprising treatment facilities, community and family resources are very important to improve medication adherence. Effective tuberculosis management through health teams training seems necessary. Incorporating simple screening instruments for depression assessment might promote well-being and patient adherence.
基金This research(study design,data collection and analysis)was funded by Program Riset Kolaborasi Indonesia(RKI)-World Class University(WCU)Lembaga Penelitian dan Pengabdian Masyarakat Universitas Airlangga Indonesia in 2023 with the number:974/UN3.LPPM/PT.01.03/2023.
文摘Objectives:Addressing the issue of mental health disorders in the community is a significant challenge for Indonesia’s healthcare professionals.This study aimed to explore the challenges that community health workers(CHWs)encounter while providing mental health services in the community.Methods:Forty CHWs were selected to participate in the study by purposive sampling method from July to August 2023 in seven primary health centers(PHCs)among three cites of Indonesia.Focus group discussions were used to collect data.All of data were analyzed using the interpretive phenomenological analysis method.Results:Considering the participants’voluntary CHW role,the results were organized into five themes.These comprised two themes of challengesdfamily stigma and limited understanding of mental disorders,and three themes regarding efforts to overcome the challengesdmaintaining self-motivation,fostering self-efficacy,and using communication skills when approaching families and patients.Conclusions:Upskilling and empowering CHWs helps to enhance community mental health.Thus,it is crucial to support CHWs through training programs that aim to improve mental health literacy and communication skills and diminish family stigma.
文摘目的:引进简明幸福与生活质量满意度问卷(Quality of Life Enjoyment and Satisfaction Ques-tionnaire,Short Form,Q-LES-Q-SF),评估其在中国精神障碍患者中的信效度和适用性。方法:在山东省精神卫生中心2007年7月-2008年1月的门诊和住院患者中,按照就诊或住院的先后顺序,选取385例符合《ICD-10精神与行为障碍分类》诊断标准的精神分裂症(n=193)和心境障碍患者(n=192);按1∶2的比例选取与其相匹配的健康对照者196例。对所有对象进行Q-LES-Q-SF初次测评,30天后进行重测,对原始测评结果进行信度分析。以世界卫生组织生活质量量表(World Health Organization Quality of Life,WHO-QOL-100)为效标变量评价患者和健康对照者效标效度并进行区分效度分析。结果:信度分析显示量表的Cronbacnα系数为0.920,重测信度为0.785。总量表评分与WHOQOL-100总分及6个领域和24个方面均具有较高的相关性(心境障碍,r=0.22～0.71;精神分裂症,r=0.24～0.70;健康对照,r=0.17～0.73;Ps<0.01)。精神分裂症组和心境障碍组患者的幸福与生活质量满意度总分及各条目分均低于健康对照组[如总分,(46.42±8.36)vs.(54.34±8.11),(46.20±10.12)vs.(54.34±8.11),Ps<0.01]。结论:简明幸福与生活质量满意度问卷在中国精神障碍患者中有较好的信效度,适用于精神障碍患者生活质量的量化评估。
