scholarly journals Socialization of self-care guidelines for tuberculosis patients at UPT Pulmonary Health Services in West Kalimantan Province

2021 ◽  
Vol 6 (11) ◽  
pp. 2058-2062
Author(s):  
Tri Wahyuni ◽  
Parliani Parliani ◽  
Tutur Kardiatun ◽  
Prasetyo Aji Nugroho ◽  
Al Fikri ◽  
...  
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Self Care ◽  
Psychosocial Problems ◽  
Intensive Phase ◽  
West Kalimantan ◽  
Tb Treatment ◽  
Service Activity ◽  
Care Guidelines

Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which can harm the lungs and attack other organs. This will result in nursing issues, the risk of infection spreading to other organs and people, ineffective airway clearance, impaired gas exchange, nutritional disorders, and psychosocial problems. Efforts are made to overcome nursing problems by increasing the participation of patients and families, who serve as the primary supporters. The intervention performed by the patient as an agent for himself is known as self-care. Self-care is concerned with an individual's ability to care for and maintain his or her own health. Treatment, family support, and nutritional fulfillment are all part of TB treatment. The outcomes of service activity at UPT Pulmonary Health Services includes teaching health workers about self-care for TB patients, as well as conducting follow-up discussions about TB patients with anxiety in the intensive phase.

scholarly journals Health workers’ perceptions on where and how to integrate tobacco use cessation services into tuberculosis treatment; a qualitative exploratory study in Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizeus Rutebemberwa ◽  
Kellen Nyamurungi ◽  
Surabhi Joshi ◽  
Yvonne Olando ◽  
Hadii M. Mamudu ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Tobacco Cessation ◽  
Health Workers ◽  
High Volume ◽  
Health Facilities ◽  
Hospital Treatment ◽  
Management Support ◽  
Tobacco Use Cessation ◽  
Tb Treatment

Abstract Background Tobacco use is associated with exacerbation of tuberculosis (TB) and poor TB treatment outcomes. Integrating tobacco use cessation within TB treatment could improve healing among TB patients. The aim was to explore perceptions of health workers on where and how to integrate tobacco use cessation services into TB treatment programs in Uganda. Methods Between March and April 2019, nine focus group discussions (FGDs) and eight key informant interviews were conducted among health workers attending to patients with tuberculosis on a routine basis in nine facilities from the central, eastern, northern and western parts of Uganda. These facilities were high volume health centres, general hospitals and referral hospitals. The FGD sessions and interviews were tape recorded, transcribed verbatim and analysed using content analysis and the Chronic Care Model as a framework. Results Respondents highlighted that just like TB prevention starts in the community and TB treatment goes beyond health facility stay, integration of tobacco cessation should be started when people are still healthy and extended to those who have been healed as they go back to communities. There was need to coordinate with different organizations like peers, the media and TB treatment supporters. TB patients needed regular follow up and self-management support for both TB and tobacco cessation. Patients needed to be empowered to know their condition and their caretakers needed to be involved. Effective referral between primary health facilities and specialist facilities was needed. Clinical information systems should identify relevant people for proactive care and follow up. In order to achieve effective integration, the health system needed to be strengthened especially health worker training and provision of more space in some of the facilities. Conclusions Tobacco cessation activities should be provided in a continuum starting in the community before the TB patients get to hospital, during the patients’ interface with hospital treatment and be given in the community after TB patients have been discharged. This requires collaboration between those who carry out health education in communities, the TB treatment supporters and the health workers who treat patients in health facilities.

scholarly journals ANALYSIS OF HEALTH POLICY IN THE BORDER AREA OF WEST KALIMANTAN INDONESIA

2017 ◽  
Author(s):  
Abil Rudi
Keyword(s):  
Health Policy ◽  
Health Status ◽  
Health Services ◽  
Local Community ◽  
Health Workers ◽  
Health Care Facilities ◽  
Health Policies ◽  
Border Area ◽  
West Kalimantan ◽  
Border Areas

Background : The health status of the people in the border areas with low economic level, especially in rural areas, have not received equitable health services optimally due to geographical location, infrastructure and social. In addition, the border area with vast areas still found the lack facilities and infrastructure of hea lth services that will be make people in the border area is still low in accessing health care facilities. On the other hand, the health workers who are not willing to be placed in the border area has a big influence and that’s lowering the community health status. Problems of inequality health efforts in the border area also caused by the socioeconomic status of the local community which is poverty so that can’t access the health services. Objective : This study aims to analyze the implementation of health policies in the border areas in West Kalimantan, Indonesia. Method : This study is a descriptive study with qualitative approach. This study is a literature study research. Results : Health policy in border area has not been able to overcome the problems of the spread of health workers in the border area. Policies on the health insurance system in the border areas are not distributed optimally. Policies on basic health infrastructure in border areas have not been equally distributed. Policies on referral transportation in border areas are not yet sufficient. Conclusion : The implementation of health policies in the border areas have not been fit for the purposes to increase health status for community.

scholarly journals Improving Oral Oncolytic Patient Self-Management

2016 ◽  
Vol 12 (9) ◽  
pp. e864-e869 ◽  
Author(s):  
Elaine McNamara ◽  
Lindsey Redoutey ◽  
Emily Mackler ◽  
Jane A. Severson ◽  
Laura Petersen ◽  
...  
Keyword(s):  
Medical Records ◽  
Tracking System ◽  
Self Care ◽  
Self Assessment ◽  
Start Date ◽  
Phone Calls ◽  
Edmonton Symptom Assessment Scale ◽  
Care Guidelines ◽  
Oral Oncolytics

Purpose: Managing patients who are taking oral oncolytics is challenging because of the changing paradigm from frequent supervision during intravenous therapy to periodic observation with oral administration of drugs. We joined the Michigan Oncology Quality Consortium (MOQC) Oral Oncolytics Collaborative in 2013 to identify opportunities for improvement in this area. Methods: We completed MOQC’s baseline self-assessment and performed an audit of medical records for 25 patients prescribed an oral oncolytic from May 2011 to July 2013. We implemented the following MOQC resources: a tracking system for patients taking oral oncolytics, patient education with drug-specific self-care guidelines, use of a modified Edmonton Symptom Assessment Scale, and a medication adherence questionnaire to be used on scheduled follow-up calls and return visits. We modified our workflow to include a standard teaching session and consistent follow-up phone calls. We conducted a retrospective postimplementation medical records audit from August 2013 to September 2014. Results: Baseline self-assessment revealed lack of start date documentation and lack of consistent follow-up. A baseline medical records audit showed that 48% of patients discontinued their medication without consulting their physician, and start date documentation was available for only 52% of patients. After participating in the quality initiative, 100% of patients sampled had a documented start date, and no patients discontinued their drug on their own. Seventeen percent had a dose reduction as a result of toxicity, as directed by the physician. Conclusion: The introduction of new office procedures to easily identify all patients receiving oral therapy and improvement in patients’ ability to manage symptoms at home with the use of self-care guidelines contributed to an improvement in managing patients who are taking oral oncolytics.

scholarly journals PELATIHAN DALAM PENGGUNAAN INFORMED CONSENT PADA FASILITAS PELAYANAN KESEHATAN

2021 ◽  
Vol 5 (1) ◽  
pp. 244
Author(s):  
Arief Setiyoargo ◽  
Romaden Marbun ◽  
Richard One Maxelly
Keyword(s):  
Informed Consent ◽  
Health Services ◽  
Community Service ◽  
Health Workers ◽  
Health Care Facilities ◽  
Online Discussions ◽  
Initial Assessment ◽  
Current State ◽  
Service Activity ◽  
Google Drive

ABSTRAKKegiatan Pengabdian kepada Masyarakat ini bertujuan untuk meningkatkan kualitas pelayanan kesehatan melalui pemahaman penggunaan informed consent. Kegiatan ini diawali dengan penilaian awal kondisi terkini di lapangan di fasilitas pelayanan kesehatan melalui petugas kesehatan/kader kesehatan dan warga. Asesmen awal menemukan masih kurangnya pengetahuan masyarakat tentang penanganan medis bagi pasien dan pengetahuan terkait penggunaan informed consent di fasilitas kesehatan terutama pada masa pandemi Covid-19 saat ini, fokus pelayanan kesehatan masih berpusat pada kesehatan. protokol atau jarak fisik. Kegiatan diawali dengan penyusunan rencana dan jadwal kegiatan serta perlengkapan yang diperlukan. Pelaksanaan kegiatan dilakukan dengan memberikan penyuluhan dan pendampingan yang dikemas dalam bentuk materi dan video yang dibagikan melalui google drive secara serta diskusi secara online melalui grup WhatsApp. Kegiatan diakhiri dengan evaluasi menggunakan google form. Hasil kegiatan pengabdian masyarakat terdapat sebanyak 57,69% pemahaman warga dalam kategori baik, 26,92% cukup dan 15,38% kurang. Kegiatan berjalan dengan baik dan perlu pemantauan lebih lanjut. Kata kunci: tenaga kesehatan; pasien; informed consent. ABSTRACTThis Community Service activity aims to improve the quality of health services through understanding the use of informed consent. This activity begins with an initial assessment of the current state of the field in health care facilities through health workers/health cadres and residents. The initial assessment found that there was still a lack of public knowledge about medical treatment for patients and knowledge related to the use of informed consent in health facilities, especially during the current Covid-19 pandemic, the focus of health services is still centered on health protocols or physical distancing. The activity begins with preparing a plan and schedule of activities as well as the necessary equipment. The activities are carried out by providing counseling and assistance packaged in the form of materials and videos that are distributed via Google Drive as well as online discussions through WhatsApp groups. The activity ended with an evaluation using a google form. The results of community service activities there are as many as 57,69% of citizens' understanding in the good category, 26,92% sufficient and 15,38% less. Activities are going well and need further monitoring. Keywords: health worker; patient; informed consent 

scholarly journals PO 8544 USE OF XPERT MTB/RIF ASSAY AND FDA MICROSCOPY RELATIVE TO MONTHLY CULTURES IN MONITORING MULTIDRUG-RESISTANT TUBERCULOSIS PATIENTS IN BAMAKO, MALI

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A51.3-A52
Author(s):  
Bassirou Diarra ◽  
B Aissata ◽  
Tom Decroo ◽  
Marie L Keita ◽  
Boureima Degoga ◽  
...  
Keyword(s):  
Vital Staining ◽  
Multidrug Resistant ◽  
Alternative Methods ◽  
Intensive Phase ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Resource Limited ◽  
Mgit Culture

IntroductionXpert MTB/RIF assay is used extensively for the detection of rifampicin-resistant TB (RR-TB). RR-TB treatment monitoring is culture-based, although, in resource-limited settings, access to TB culture is poor. Alternative methods are needed. We therefore conducted a pilot study to determine the performance of fluorescein di-acetate FDA vital staining, a microscopy-based test that shows viable bacilli, and Xpert threshold cycle value (Ct) changes when assessing culture conversion at the end of the intensive phase of RR-TB treatment.MethodsBetween December 2015 and April 2018, we prospectively followed patients with RR-TB during the 6-month intensive phase of a 21-month standardised WHO treatment regimen. Sputum was collected and tested monthly with Auramine, FDA, Xpert MTB/RIF, and culture (Manual MGIT). Culture was considered to have converted to negative when two consecutive cultures, taken at least 30 days apart, were negative, including at least one culture between 4–6 months of treatment.ResultsForty-one patients were included in this study, 80% were male and 7% were HIV-co-infected. Conversion could not be assessed in 12 (29%) patients. Among the remaining 29 patients, 9 (31%) converted, and 11 (38%) did not convert. All 9 who converted on culture had a negative FDA, and most (6) had a Ct trend that showed a reduction of excreted DNA (increasing Ct trend). Three of these were still positive on Auramine (excretion of dead bacilli?). Of 11 patients with positive cultures, 8 tested negative on FDA, 5 tested ‘MTB not detected’ on Xpert MTB/RIF, and another 2 showed a reduction of excreted DNA.ConclusionResults from culture, FDA, and Xpert MTB/RIF provide similar results among converters but contrasting results among non-converters. Longer follow-up time is needed to assess the value of these tests to predict treatment outcome.

scholarly journals Video directly observed therapy for supporting and monitoring adherence to tuberculosis treatment in Uganda: a pilot cohort study

2020 ◽  
Vol 6 (1) ◽  
pp. 00175-2019 ◽  
Author(s):  
Juliet N. Sekandi ◽  
Esther Buregyeya ◽  
Sarah Zalwango ◽  
Kevin K. Dobbin ◽  
Lynn Atuyambe ◽  
...  
Keyword(s):  
Cohort Study ◽  
Primary Outcome ◽  
Health Workers ◽  
Secondary Analysis ◽  
Directly Observed Therapy ◽  
Tb Control ◽  
Tb Treatment ◽  
Kampala City ◽  
The Mean

IntroductionNonadherence to treatment remains an obstacle to tuberculosis (TB) control worldwide. The aim of this study was to evaluate the feasibility of using video directly observed therapy (VDOT) for supporting TB treatment adherence in Uganda.MethodsFrom May to December 2018, we conducted a pilot cohort study at a TB clinic in Kampala City. We enrolled patients aged 18–65 years with ≥3 months remaining of their TB treatment. Participants were trained to use a smartphone app to record videos of medication intake and submit them to a secured system. Trained health workers logged into the system to watch the submitted videos. The primary outcome was adherence measured as the fraction of expected doses observed (FEDO). In a secondary analysis, we examined differences in FEDO by sex, age, phone ownership, duration of follow-up, reasons for missed videos and patients' satisfaction at study exit.ResultsOf 52 patients enrolled, 50 were analysed. 28 (56%) were male, the mean age was 31 years (range 19–50 years) and 35 (70%) owned smartphones. Of the 5150 videos expected, 4231 (82.2%) were received. The median FEDO was 85% (interquartile range 66%–94%) and this significantly differed by follow-up duration. Phone malfunction, uncharged battery and VDOT app malfunctions were the commonest reasons for missed videos. 92% of patients reported being very satisfied with using VDOT.ConclusionVDOT was feasible and acceptable for monitoring and supporting TB treatment. It resulted in high levels of adherence, suggesting that digital technology holds promise in improving patient monitoring in Uganda.

scholarly journals Health services utilization of Chinese patients with Huntington's disease: A cross-sectional study

2021 ◽  
Author(s):  
Huiyi Ke ◽  
Xi Cao ◽  
Yanyan Song ◽  
Li Cao
Keyword(s):  
Logistic Regression ◽  
Health Insurance ◽  
Health Services ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Health Services Utilization ◽  
Self Care ◽  
Services Utilization ◽  
Medical Visits

Abstract Background Huntington’s disease (HD) is a hereditary disease which could have a large impact on patients’ quality of life. As the neurodegenerative disorders progress, HD patients are expected to regularly take follow-up medical visits for proper treatment. This study aimed to analyze the general situation of health services utilization of Chinese HD patients and factors associated with their adherence to follow-up medical visits. Methods We collected data from a questionnaire-based investigation conducted by Chinese Huntington's Disease Association. Data from 232 respondents were included to investigate whether they adhered to regular follow-up medical visits and the cause and correlates. Based on Andersen’s behavioral model, the independent variables were categorized into predisposing, enabling and need factors. The variables were analyzed by chi-square test and stepwise logistic regression analysis. Results 31.9% of the respondents had regular follow-up medical visits over the past year. Univariate analysis showed there were significant differences with 6 factors (P < 0.05), among which, according to logistic regression, 2 enabling factors (reimbursement of health insurance, need for accompanying family members to follow-up visits) and 3 need factors (perceived stage of disease, perceived effectiveness of drugs, self-care ability) were independent influencing factors of follow-up medical behaviors of Chinese HD patients. The predisposing factors investigated here did not play a part in determining patients’ adherence to follow-up visits. Conclusions Poor adherence to medical visits among Chinese HD patients is derived from multiple factors, including reimbursement of health insurance, perceived stage of disease and effectiveness of drugs, need for accompanying family members and self-care ability. To promote HD patients’ health services utilization, the improvement of health insurance system, the enhancement of social support and the development of therapeutic approaches still have a way to go.

scholarly journals Monitoring Of Side Effects Of Anti-Tuberculosis Drugs (ATD) On The Intensive Phase Treatment Of Pulmonary TB Patients In Makassar

2017 ◽  
Vol 3 (1) ◽  
pp. 19
Author(s):  
Akhmadi Abbas
Keyword(s):  
Side Effects ◽  
Joint Pain ◽  
Health Workers ◽  
Treatment Compliance ◽  
Patient Treatment ◽  
Intensive Phase ◽  
Loss To Follow Up ◽  
Pulmonary Tb ◽  
Loss Of Appetite

Side effects of Anti-Tuberculosis Drugs (ATD) is a problem in the treatment of TB patients. The severity of the side effects experienced by patients will have an impact on treatment compliance and loss to follow-up rate. This study aimed to obtain information about ATD side effects experienced by pulmonary TB patients during the intensive phase treatment in Makassar. This type of research was observational descriptive with the time series design. The number of samples in this study were 58 people. The results showed that the percentage of patients who experienced ATD side effects during the intensive phase of treatment is the first week of 96.6%, 91.4% the second week, third week of 86.2%, 74.1% fourth week, the fifth week 74.1% , the sixth week 81%, the seventh week of 75.9% and 67.2% eighth week. The percentage of patients based on the type of side effects experienced is 81% joint pain, nausea 79.3%, 77.6% itching, loss of appetite 75.9%, 67.2% dizziness, tingling 50%, vomiting 41.4%, 34.5% abdominal pain, visual disturbances 27.6%, headache 24.1% and 6.9% hearing loss. This study showed that patients experienced ATD side effects every week during the intensive phase treatment. More side effects experienced during the first and the second weeks and tend to decrease until the end of the intensive phase. The main type of side effects experienced by TB patients are joint pain. Health workers should always conduct routine monitoring of ATD side effects experienced by TB patients in order to improve patient treatment compliance and prevent them from loss to follow-up of treatment. Keywords: Monitoring, Side effects, ATD, TB, Intensive phase

scholarly journals The preparation of the nurse in the tuberculosis field

Curationis ◽  
1982 ◽  
Vol 5 (3) ◽  
Author(s):  
J.G.P. Van Niekerk
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Past Century ◽  
The Past ◽  
Primary Health ◽  
The People ◽  
First Contact

Nursing has grown and developed profusely during the past century to where it’s practitioners today render indispensable services to the people of this country. Nurses are active in all the spheres related to health services and as the primary health workers, are usually the first contact with the patient. Therefore her role in the detection, identification, treatment, referral, follow-up and rehabilitation of patients suffering from tuberculosis can never be underestimated. To be able to fulfil this role it speaks for itself that nurses will need training to render the best possible service.

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