scholarly journals A qualitative study of perspectives on access to tuberculosis health services in Xigaze, China

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Victoria Haldane ◽  
Zhitong Zhang ◽  
Qi Ma ◽  
Tingting Yin ◽  
Bei Zhang ◽  
...  
Keyword(s):  
Rural Communities ◽  
Qualitative Study ◽  
Barriers And Facilitators ◽  
Tibetan Medicine ◽  
Pathways To Care ◽  
Comprehensive Treatment ◽  
Framework Analysis ◽  
Autonomous Region ◽  
Tibet Autonomous Region ◽  
Out Of Pocket Payments

Abstract Background Tuberculosis (TB) is a major global health threat and the leading infectious disease cause of death worldwide. Access to and retention in TB care remains a challenge for patients, particularly those living in rural and remote settings. This qualitative study explored barriers and facilitators to accessing and maintaining contact with TB care services in communities in Xigaze (Shigatse) prefecture, Xizang Autonomous Region (Tibet Autonomous Region), China from the perspective of persons impacted by TB. Methods We conduced in-depth interviews with 23 participants impacted by TB in four rural districts in Xigaze prefecture, Xizang Autonomous Region, China between April 2019 and November 2020. Interviews were conducted in Tibetan and Mandarin, transcribed in Mandarin and translated into English. Transcripts were checked against recordings by native Tibetan and Mandarin speakers. QSR NVivo12 software was used for framework analysis guided by an access to care conceptual framework by Levesque et al. Results Overall patients reported low awareness of and an indifferent attitude towards TB, although all reported understanding the need to adhere to treatment. Participants reported complex pathways to care, often requiring visits to multiple healthcare facilities. Some participants reported visiting traditional Tibetan medicine (TTM) providers. Participants reported various barriers to accessing care including challenges physically reaching care, out-of-pocket payments for tests, diagnostics and transport. Barriers to maintaining care included medication side effects and worry about treatment effectiveness. Enablers to accessing care identified included knowledge or past experience with TB, integrated models of TTM and western care, supportive village doctors who conducted home visits, free TB treatment and other subsidies, as well as having family support with care and social support as barriers and facilitators to maintaining treatment. Conclusions We identified barriers and facilitators to accessing services in rural communities in Xigaze from the perspective of persons impacted by TB. Challenges include complex pathways to care, travel distances, wait times and low awareness. Tuberculosis care in the region could be strengthened by ongoing culturally tailored educational campaigns to increase awareness, partnerships with TTM providers, providing comprehensive treatment subsidies and strengthening the role of family members in comprehensive TB care. Graphic abstract

scholarly journals The anticipated and the lived experience of home and in-centre haemodialysis: Is there a disconnect?

2016 ◽  
Vol 22 (12) ◽  
pp. 1524-1533 ◽  
Author(s):  
Rabiya Majeed-Ariss ◽  
A Jayanti ◽  
T Schulz ◽  
A Wearden ◽  
S Mitra
Keyword(s):  
Qualitative Study ◽  
Lived Experience ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Patient Factors ◽  
Home Haemodialysis ◽  
Advantages And Disadvantages ◽  
Patients Experience

This qualitative study aimed to explore home haemodialysis and in-centre haemodialysis patients’ experience, to illuminate barriers and facilitators in the uptake and maintenance of home haemodialysis. Thirty-two semi-structured interviews with patients receiving home haemodialysis or in-centre haemodialysis were analysed using framework analysis. Four themes emerged: ‘perceptions of self’; ‘impact of haemodialysis on family’; ‘perceived advantages and disadvantages of home haemodialysis and in-centre haemodialysis’ and ‘practical issues and negotiating haemodialysis’. The lived experience of home haemodialysis was in contrast to the lived experience of in-centre haemodialysis and to the anticipated experience of home haemodialysis, highlighting patient factors that contributed to under-usage of home haemodialysis.

Socio-Economic Dimensions of Tibetan Medicine in the Tibet Autonomous Region, China Part One

2008 ◽  
Vol 4 (1) ◽  
pp. 174-200 ◽  
Author(s):  
Theresia Hofer
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Rural China ◽  
Tibetan Medicine ◽  
Medical Practitioners ◽  
Autonomous Region ◽  
Tibet Autonomous Region ◽  
Anthropological Fieldwork ◽  
Anthropological Literature ◽  
The Tibet Autonomous Region

AbstractThis article investigates some of the socio-economic dimensions of contemporary Tibetan healing practices in the rural areas of the Tibet Autonomous Region (TAR) in China. It sheds light on the workings and the effects the commodification of the official Chinese health care system, which started in the late 1990s, have had on Tibetan medicine and how these are related to the concurrent re-introduction of the Co-operative Medical Services (CMS) scheme throughout rural China. The contribution to this journal is divided into two parts. Part One predominantly deals with the medical practitioners and the practices within governmental health care in the TAR. Part Two, which will be printed in the next issue of the journal, deals with the private sector of Tibetan medicine. Both parts focus on the situation in the Tsang or Shigatse region of the western and central TAR, hence enabling there to be useful comparisons with medical practices in the capital Lhasa, most of the anthropological literature has focused on so far. Both contributions are based on extensive anthropological fieldwork in Lhasa and the Tsang region of Tibet.

scholarly journals Thoughts on the Precarious State of Medicinal Herbs and Plants in the Tibet Autonomous Region and Ideas About Their Protection

2009 ◽  
Vol 5 (2) ◽  
pp. 385-393
Author(s):  
Tsering D. Gonkatsang ◽  
Kalden Nyima
Keyword(s):  
Current Situation ◽  
Medicinal Herbs ◽  
Tibetan Medicine ◽  
Autonomous Region ◽  
Tibet Autonomous Region ◽  
The Future ◽  
Traditional Tibetan Medicine ◽  
The Tibet Autonomous Region

This paper, translated from the Tibetan original, presents the author’s viewpoint on the current situation regarding the protection of medicinal herbs and vegetation—the sources of Tibetan medicine—and makes recommendations on measures that should be taken for their protection in the future. The article also includes an appendix listing species names of plants that are A) particularly rare or endangered, and B) the subjects of conservation efforts and/or cultivation trials through the Project to Strengthen Traditional Tibetan Medicine (PSTTM), which is based in Lhasa, Tibet Autonomous Region (TAR), China.

Socio-Economic Dimensions of Tibetan Medicine in the Tibet Autonomous Region, China

2008 ◽  
Vol 4 (2) ◽  
pp. 492-514 ◽  
Author(s):  
Theresia Hofer
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Rural Areas ◽  
Tibetan Medicine ◽  
Medical Practices ◽  
Medical Practitioners ◽  
Autonomous Region ◽  
Tibet Autonomous Region ◽  
The Tibet Autonomous Region ◽  
Care System

AbstractThis article investigates some of the socio-economic dimensions of contemporary Tibetan medical practices in the rural areas of the Tibet Autonomous Region (TAR), China. The article is divided into two parts. Part One, printed in the last issue of the journal, deals with traditional medical practitioners and their medical practices within the governmental health care system in the TAR. It sheds light on the workings and the effects that the commodification of the official health care system have had on its Tibetan medical practitioners, most of whom now work as hybrid practitioners and incorporate Chinesestyle biomedicine into their practice. I argue that several historical, social and political factors have brought about unequal access and availability of Tibetan medicine as compared to Chinese style biomedical care in the rural areas. Special attention is given to the role of the reintroduction of the Cooperative Medical Services (CMS) scheme in the sidelining of Tibetan medical practices in the rural areas. Part Two describes the work of private Tibetan medical practitioners and explores some of the social dynamics and ethical dilemmas that have arisen for them due to the commodification of the official system and the reintroduction of the CMS. Both parts focus on the situation in the Tsang or Shigatse region of the western and central TAR, hence enabling there to be useful comparisons with medical practices in the capital Lhasa, where most of the anthropological literature has focused on so far. Both contributions are based on extensive anthropological fieldwork in Lhasa and the Tsang region of Tibet.

scholarly journals Effects of management of infection source of echinococcosis in Linzhi, Tibet Autonomous Region of China

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ying Wang ◽  
Bing-Cheng Ma ◽  
Li-Ying Wang ◽  
Gongsang Quzhen ◽  
Hua-Sheng Pang
Keyword(s):  
Infection Rate ◽  
Domestic Dog ◽  
Enzyme Linked Immunosorbent Assay ◽  
Fecal Samples ◽  
Autonomous Region ◽  
Prevention Campaign ◽  
Tibet Autonomous Region ◽  
Control And Prevention ◽  
Infection Source ◽  
Dog Infection

Abstract Background Echinococcosis is highly endemic in western and northern China. Tibet Autonomous Region (TAR) is the most serious prevalent area. Linzhi is located in southeastern part of TAR. Dogs are the primary infection source for the transmission of echinococcosis to humans. A control and prevention campaign based on dog management has been implemented in the past three years. This study aims to evaluate the effects of dog management on the infection rate of dogs. Methods Data of dog population, registration and de-worming of seven counties/district in Linzhi between 2017 and 2019 were obtained from the annual prevention and control report. Domestic dog fecal samples were collected from each endemic town of seven counties/district in Linzhi in 2019 to determine the infection of domestic dogs using coproantigen enzyme-linked immunosorbent assay (ELISA). Data analysis was processed using SPSS statistics to compare dog infection rate between 2016 and 2019 by chi-square test, and maps were mapped using ArcGIS. Results In Linzhi, domestic dog population has decreased from 17 407 in 2017 to 12 663 in 2019, while the registration rate has increased from 75.9% in 2017 to 98.6% in 2019. Similarly, stray dog population has decreased from 14 336 in 2017 to 11 837 in 2019, while sheltered rate has increased from 84.6% in 2017 to 96.6% in 2019. Dog de-worming frequency has increased from 4 times per annum in 2017 to 12 times in 2019, indicating that approximately every dog was dewormed monthly. A total of 2715 dog fecal samples were collected for coproantigen ELISA assay. The dog infection rate was 2.8% (77/2715) in 2019, which was significantly lower than 7.3% (45/618) in 2016 (P < 0.05). Conclusions Increased dog registration, decreased dog population, and increased dog de-worming frequency contributed to significantly decrease the dog infection rate in Linzhi. Control and prevention campaign based on dog management could significantly decrease dog infection with Echinococcus spp. in echinococcosis endemic areas.

scholarly journals Medication Experience and Adherence to Oral Chemotherapy: A Qualitative Study of Patients’ and Health Professionals’ Perspectives

2021 ◽  
Vol 18 (8) ◽  
pp. 4266
Author(s):  
Amparo Talens ◽  
Mercedes Guilabert ◽  
Blanca Lumbreras ◽  
María Teresa Aznar ◽  
Elsa López-Pintor
Keyword(s):  
Qualitative Study ◽  
Health Professionals ◽  
Real Life ◽  
Positive Influence ◽  
Barriers And Facilitators ◽  
University Hospital ◽  
Nominal Group ◽  
Care Plans ◽  
Individualized Care ◽  
Medication Experience

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals’ perspectives. We carried out an exploratory qualitative study in the University Hospital of San Juan de Alicante, Spain. Three focus groups and two nominal group discussions were conducted with 23 onco-hematological patients treated with ANEO and 18 health professionals, respectively. The data were analyzed using content analyses and were eventually triangulated. The most impactful aspects in patients’ ME were the presence of adverse effects; lack of information about treatment; beliefs, needs and expectations regarding medications; social and family support; and the relationship with the health professionals. Both patients and professionals agreed on considering the negative side effects and the information about treatment as the main barriers and facilitators of adherence, respectively, although the approaches differed between both profiles. The professionals offered a more technical vision while patients prioritized the emotional burden and motivation associated with the disease and medication. This study allowed us to understand the real-life experiences of patients being treated with ANEO and explore the factors which had an impact on adherence to treatment. This understanding enables professionals to have a positive influence on patients’ behavior and provide individualized care plans. Pharmacists’ assistance is relevant to support patients’ adherence and self-management.

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