scholarly journals Barriers and facilitators of nutrition assessment, counseling, and support for tuberculosis patients: a qualitative study

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Meaza Girma Degefa ◽  
Afework Mulugeta Bezabih ◽  
Znabu Hadush Kahsay ◽  
Abate Bekele Belachew
Keyword(s):  
Qualitative Study ◽  
Care Provider ◽  
Weak Link ◽  
Support Service ◽  
Nutrition Assessment ◽  
Barriers And Facilitators ◽  
Organizational Level ◽  
Northern Ethiopia ◽  
Tuberculosis Patients ◽  
Patient Level

Abstract Background Nutrition has a substantial role in the prevention, treatment, and cure of tuberculosis. Thus, nutrition assessment, counseling, and support (NACS) have been implemented as part of tuberculosis treatment. However, evidence on the barriers and facilitators (enablers) of its implementation is lacking. Objective To explore barriers and facilitators of implementation of NACS for tuberculosis patients. Methods An exploratory qualitative study was conducted in public health facilities and health offices of Mekelle City, Northern Ethiopia. We conducted 17 interviews using purposively selected key informants comprising health professionals (n = 12) and tuberculosis patients (n = 5). Interviews were tape-recorded, transcribed verbatim, and coded and analyzed using a thematic approach in ATLAS.ti 7 software. Results Barriers were identified at three levels -organization, care provider, and patient levels. Suboptimal nutritional supply, lack of supportive supervision, lack of adequate workforce, staff turn-over, the sudden withdrawal of partners, and weak link with social service were the barriers at the organization level. Lack of commitment was reported as the only barrier at the care provider level, and socioeconomic status of patients, sharing and selling of supplies, perceived improved status, and perceived stigma were identified as the major barriers for the implementation of nutrition assessment, counseling, and support service. While training, availability of measurement and educational tools, the inclusion of nutrition indicators in the tuberculosis register, and the presence of collaborating partners were identified as facilitators at the organizational level. Patients’ motivation to know their health status was reported to be a facilitator at the patient level. Conclusions Organization, care provider, and patient-level barriers and facilitators were found to influence the implementation of NACS. Hence, multilevel factors should be considered to successfully implement the program and to gain its potential impact.

scholarly journals Barriers and facilitators of nutrition assessment, counseling and support for Tuberculosis patients: a qualitative study

2020 ◽  
Author(s):  
Meaza Girma Degefa ◽  
Afework Mulugeta Bezabih ◽  
Zinabu Hadush Kahsay ◽  
Abate Bekele Belachew
Keyword(s):  
Qualitative Study ◽  
Care Provider ◽  
Weak Link ◽  
Work Force ◽  
Nutrition Assessment ◽  
Barriers And Facilitators ◽  
Organizational Level ◽  
Northern Ethiopia ◽  
Tuberculosis Patients ◽  
Patient Level

Abstract Background: Provided the significant role of nutrition and proper diet to tuberculosis patients, nutrition assessment, counseling and support has become integral part of tuberculosis treatment. However, proper implementation is crucial to realize its effects, and the barriers and facilitators of implementation has not been studied yet. Objective: To explore barriers and facilitators of implementation of Nutrition Assessment, Counseling and Support for tuberculosis patients. Methods: An exploratory qualitative study conducted in public health facilities and health offices of Mekelle City, Northern Ethiopia. A total of 17 purposively selected key informants were interviewed. Interviews were tape-recorded, transcribed verbatim, and coded and analyzed using a thematic approach. Results: Barriers and facilitators were identified at three levels namely organization, care provider and patient levels. Suboptimal nutritional supply, lack of supportive supervision, lack of adequate work force, staff turn-over, sudden withdrawal of partners and weak link with social service were the barriers at the organization level. Lack of commitment was reported as the only barrier at care provider level and socioeconomic status of patients, sharing and selling of supplies, perceived improved status and perceived stigma were identified as the major barriers for the implementation of nutrition assessment, counseling and support services. While training, availability of measurement and educational tools, inclusion of nutrition indicators in the tuberculosis register, and presence of collaborating partners were identified as facilitators at organizational level. Patients’ motivation to know their health status was reported to be a facilitator at patient level.Conclusion and Implications: Organization, care provider and patient level barriers and facilitators found to influence the implementation. Multifaceted approaches are needed for the health system to successfully implement the program and to gain its potential impact.

scholarly journals Barriers and Facilitators to Chronic Red Cell Transfusion Therapy for Children with Sickle Cell Anemia: Results from the Displace Consortium

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4697-4697
Author(s):  
Alyssa M Schlenz ◽  
Shannon Phillips ◽  
Martina Mueller ◽  
Cathy Melvin ◽  
Robert J. Adams
Keyword(s):  
Stroke Prevention ◽  
Venous Access ◽  
Barriers And Facilitators ◽  
Organizational Level ◽  
Staff Support ◽  
Transfusion Therapy ◽  
Patient Level ◽  
Data Saturation ◽  
Red Cell Transfusion ◽  
Social Environmental

Introduction: Chronic red cell transfusion therapy (CRCT) is one of the only disease-modifying therapies for individuals with sickle cell anemia (SCA). CRCT plays a particularly critical role in stroke prevention for children with SCA who are at high risk (primary prevention) or who have had a previous stroke (secondary prevention). CRCT is also used to prevent other non-neurologic severe complications from SCA, such as recurrent splenic sequestration or severe acute chest syndrome. Only a few previous studies have focused on patient and provider experiences related to CRCT. This previous work has predominantly focused on patient/caregiver perceptions of children's quality of life while receiving CRCT and provider decision-making around CRCT for SCA. The present study sought to build on this previous work by examining barriers and facilitators to CRCT for stroke prevention as part of the aims of the Dissemination and Implementation Looking at the Care Environment (DISPLACE) study. DISPLACE is a multi-site study funded to evaluate and improve implementation of stroke prevention practices for SCA. The goal of this particular aim was to inform optimal strategies to enhance CRCT initiation for stroke prevention in SCA. Methods: A qualitative descriptive approach was used to obtain provider and patient/caregiver perspectives through key informant interviews with open-ended questions. Purposive sampling was used to identify patient/caregiver participants and purposive and snowball sampling were used to identify provider participants with the goal of enrolling participants until data saturation was reached. Interviews were digitally audio recorded and transcribed for analysis. Data were analyzed using inductive and deductive approaches. Deductive analysis followed the directed content analysis approach with the Multilevel Ecological Model of Health as an initial coding framework. Themes were developed around the barriers and facilitators to CRCT from an ecological perspective. Results: Fifty-two interviews were completed across patients/caregivers and providers (27 patient/caregivers and 25 providers) in order to reach data saturation. For patient/caregivers, 26 caregivers of children and adolescents with SCA (mean age = 39; 21 mothers, 4 fathers, and 1 aunt) and one young adult (age 18, female) completed interviews. For providers, 19 physicians, 2 nurse practitioners, 1 physician assistant, and 3 ancillary providers completed interviews (mean age = 50; 14 female; mean years of practice in SCA = 18.8). Patient/caregiver and provider themes were consistent with the multi-ecological framework and reflected barriers and facilitators at the patient, provider, organizational, and social-environmental/policy levels (Figure 1). Predominant (or high-frequency) themes with definitions and illustrative quotes are presented in Table 1. Predominant barriers reported by patients/caregivers and providers included: logistical challenges (patient level), obtaining and maintaining venous access (patient level), and alloantibodies/alloimmunization and transfusion reactions (patient level). A predominant barrier reported by providers was iron overload and adherence to chelation therapy (patient level). Predominant facilitators reported by patient/caregivers and providers included: nursing and non-nursing staff support (provider level), positive child/family experience (organizational level), and logistical help and social resources (social-environmental and policy level). Predominant facilitators reported by providers included transfusion-specific resources (organizational level) and proximity to a blood bank and access to blood (organizational level). Conclusions: Patient/caregivers and providers reported a range of barriers and facilitators to CRCT, though most occurred at the patient and organizational levels. Many of the barriers and facilitators also involved interactions across ecological levels. Results suggest interventions should address predominant and remediable barriers (e.g., logistical challenges and obtaining and maintaining venous access) and incorporate predominant facilitators (e.g., nursing and non-nursing staff support and positive child/family experience). Findings from this study may be used to guide interventions for improving CRCT initiation among children with SCA. Disclosures Adams: GBT: Consultancy, Other: consultancy to companies GBT and Blueburd Bio; Bluebird: Consultancy.

Patient-level barriers and facilitators to sustaining collaborative care programs for underserved minorities: A qualitative study

2020 ◽  
Vol 67 ◽  
pp. 169-170
Author(s):  
Melissa Dong ◽  
Ludwing Flórez Salamanca ◽  
Vivian Medina ◽  
Jenny Yenilshia Firpo-Greenwood ◽  
Eileen J. Carter ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Collaborative Care ◽  
Barriers And Facilitators ◽  
Patient Level ◽  
Underserved Minorities

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.

scholarly journals Barriers and Facilitators to Promoting Resilience to HIV/AIDS: A Qualitative Study on the Lived Experiences of HIV-Positive, Racial and Ethnic Minority, Middle-Aged and Older Men Who Have Sex with Men from Ontario, Canada

2021 ◽  
Vol 18 (15) ◽  
pp. 8084
Author(s):  
Renato M. Liboro ◽  
Sherry Bell ◽  
Brandon Ranuschio ◽  
Lianne Barnes ◽  
Jenna Despres ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Ethnic Minority ◽  
Lived Experiences ◽  
Barriers And Facilitators ◽  
Research Approach ◽  
Middle Aged ◽  
Community Based ◽  
Sex With Men ◽  
Racial And Ethnic Minority ◽  
Hiv Aids

Evidence-based research has highlighted the need for exploring factors that support the mental health of men who have sex with men living with HIV/AIDS (MSMLWH), and environmental influences that promote their resilience to HIV/AIDS. This exploratory study utilized a community-based participatory research approach to investigate barriers and facilitators to promoting resilience to HIV/AIDS, specifically among racial and ethnic minority, middle-aged and older MSMLWH, a population that continues to be significantly impacted by HIV/AIDS today. This collaborative, qualitative study recruited participants who identified as racial or ethnic minority MSMLWH, were aged 40 or older, and resided in Ontario, Canada. Participants (n = 24) discussed in their interviews barriers and facilitators to promoting resilience to HIV/AIDS, which they recognized from their lived experiences. Utilizing thematic analysis, themes related to barriers and facilitators to promoting resilience to HIV/AIDS were identified. Themes related to identified barriers included: (1) language proficiency, (2) racism, (3) pernicious norms in North American gay culture, and (4) HIV stigma. Themes related to identified facilitators included: (1) compartmentalization, (2) perseverance, and (3) community-based health and social services. This article discusses the implications of the study’s findings, particularly on how they may influence the development of future services for racial and ethnic minority, middle-aged and older MSMLWH.

scholarly journals Barriers and facilitators of the uptake of digital health technology in cardiovascular care: a systematic scoping review

2021 ◽  
Author(s):  
Sera Whitelaw ◽  
Danielle M Pellegrini ◽  
Mamas A Mamas ◽  
Martin Cowie ◽  
Harriette G C Van Spall
Keyword(s):  
Organizational Support ◽  
Quantitative Methods ◽  
Digital Health ◽  
Healthcare Delivery ◽  
Health Technology ◽  
Barriers And Facilitators ◽  
User Friendliness ◽  
Eligibility Criteria ◽  
Patient Level ◽  
Cardiovascular Care

Abstract Digital health technology (DHT) has the potential to revolutionize healthcare delivery but its uptake has been low in clinical and research settings. The factors that contribute to the limited adoption of DHT, particularly in cardiovascular settings, are unclear. The objective of this review was to determine the barriers and facilitators of DHT uptake from the perspective of patients, clinicians, and researchers. We searched MEDLINE, EMBASE, and CINAHL databases for studies published from inception to May 2020 that reported barriers and/or facilitators of DHT adoption in cardiovascular care. We extracted data on study design, setting, cardiovascular condition, and type of DHT. We conducted a thematic analysis to identify barriers and facilitators of DHT uptake. The search identified 3075 unique studies, of which 29 studies met eligibility criteria. Studies employed: qualitative methods (n = 13), which included interviews and focus groups; quantitative methods (n = 5), which included surveys; or a combination of qualitative and quantitative methods (n = 11). Twenty-five studies reported patient-level barriers, most common of which were difficult-to-use technology (n = 7) and a poor internet connection (n = 7). Six studies reported clinician-level barriers, which included increased workload (n = 4) and a lack of integration with electronic medical records (n = 3).Twenty-four studies reported patient-level facilitators, which included improved communication with clinicians (n = 10) and personalized technology (n = 6). Four studies reported clinician-level facilitators, which included approval and organizational support from cardiology departments and/or hospitals (n = 3) and technologies that improved efficiency (n = 3). No studies reported researcher-level barriers or facilitators. In summary, internet access, user-friendliness, organizational support, workflow efficiency, and data integration were reported as important factors in the uptake of DHT by patients and clinicians. These factors can be considered when selecting and implementing DHTs in cardiovascular clinical settings.

scholarly journals Rights and Responsibilities of Tuberculosis Patients, and the Global Fund: A Qualitative Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0151321 ◽  
Author(s):  
Muhammad Atif ◽  
Sareema Javaid ◽  
Maryam Farooqui ◽  
Muhammad Rehan Sarwar
Keyword(s):  
Qualitative Study ◽  
Global Fund ◽  
Tuberculosis Patients
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