A rapid review of treatment literacy materials for tuberculosis patients

Brumwell, Amanda; Noyes, Elizabeth; Kulkarni, Sarah; Lin, Vanessa; Becerra, Mercedes C.; Yuen, Courtney M.

doi:10.5588/ijtld.17.0363

Cited by 7 publications

(8 citation statements)

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“…This is a point on which our department is currently working, as it could be an easy lever to activate. We try to implement a systematic written translation of TB related information for all patients in their own language, using a non-stigmatizing vocabulary and pictures, as described in the literature [34,35]. We are also currently working on picture-based flipcharts (thus overcoming language barrier and/or illiteracy), that illustrate the importance of remaining in prolonged isolation and taking anti-tuberculosis medications every day.…”

Section: Discussionmentioning

confidence: 99%

Patient-centered approach to the management of drug-resistant tuberculosis in France: How far off the mark are we?

Kherabi

Mollo

Gerard

et al. 2022

PLOS Glob Public Health

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Drug-resistant tuberculosis (DR-TB) is a major public health concern worldwide. The prolonged isolation required is a source of challenges for both healthcare workers and patients, especially in high-income countries where DR-TB patients are frequently migrants with vulnerabilities. However, data on the needs of these vulnerable patients are scarce. Our objective was to identify and quantify conflict or inappropriate care situations experienced by both DR-TB patients and healthcare workers. This 10-year retrospective observational study (01/2008 to 10/2018) was conducted in a referral center for resistant tuberculosis management in Paris, France. Sixty-five DR-TB patients were hospitalized during the study period. Their demographic, clinical and social characteristics and any conflict or inappropriate care situations they experienced with healthcare workers while hospitalized were analyzed. Conflict or inappropriate care situations with healthcare workers were reported for 24 patients during their stay (36.9%). Eleven patients (16.9%) had difficulty adhering to respiratory isolation rules, 15 (23.1%) were discharged against medical advice, 9 (13.8%) were excluded from hospital for disciplinary reasons, verbal or physical violence was reported for 7 patients (10.8%), and 4 arrests (6.2%) were made by the police. Conflict situations were reported more often when there was a language barrier (70.8%, p<0.0001). More than one-third of patients with DR-TB in this referral center experienced at least one inappropriate care situation with healthcare workers. This study illustrates the urgent need to promote a patient-centered approach and to respond to the challenges of its practical implementation.

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Section: Discussionmentioning

confidence: 99%

Patient-centered approach to the management of drug-resistant tuberculosis in France: How far off the mark are we?

Kherabi

Mollo

Gerard

et al. 2022

PLOS Glob Public Health

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“…In the present study, though the patients were reluctant to engage actively, they still wanted to communicate with their HCPs to obtain necessary information. That information provided them with an opportunity to learn about and understand their condition30 and empowered them to contribute as active partners 31,32. Earlier studies have found that acquiring basic information from HCPs is a prerequisite for PE 33.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of engagement in health care among patients with tuberculosis: a qualitative study

Ren¹,

Zhang³

et al. 2019

PPA

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PurposeAdherence to treatment is cited as a key challenge in fighting tuberculosis (TB). Treatment of TB requires patients to actively engage in their care. The purpose of this study was to explore the perceptions of patients with TB regarding their engagement in health care.Patients and methodsThe study was conducted in three medical wards in one hospital. Purposive sampling was used to recruit participants. Semi-structured, audiotaped interviews were conducted and analyzed using thematic analysis.ResultsTwenty-three patients participated in the study. Four major themes emerged: 1) devaluing engagement; 2) interacting with health care providers (HCPs); 3) facing inability; and 4) seeking external support.ConclusionThe patients’ perceptions of their engagement in health care were generally negative. Paying attention to the preferences and needs of patients and making decisions accordingly are effective strategies for promoting patient engagement. Moreover, HCPs should be aware of their crucial role in helping patients make sense of what engagement is and how to engage. In the process of engagement, providers should establish effective interactions with patients and cooperate with family and peers.

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“…Topics which would have benefitted participants in this research included additional explanation about personal and family diagnoses, the TB latency cycle and TB transmission – key for dispelling stigma-informed myths about household infection prevention. This list is by no means comprehensive, and we agree with Brumwell et al (2018) that consensus is needed on a list of essential education and counselling topics in TB. However, such a list is insufficient without efforts to strengthen patient and family member participation in education and counselling.…”

Section: Discussionmentioning

confidence: 98%

“…Other researchers (e.g. Brumwell et al, 2018; McEwen, 2005; Moodley et al, 2020) have demonstrated that TB education and counselling can be imbalanced, containing a strong focus on biomedical instructions at the expense of more fulsome explanations which help patients and family members understand TB and manage the impacts on their everyday lives.…”

Section: Discussionmentioning

confidence: 99%

“…Researchers have also expressed concern that the excessive focus on adherence in TB has resulted in clinical communication which reinforces power inequities between patients and TB HCPs (Brumwell et al, 2018; Dick and Lombard, 1997; Dick et al, 1996; Gao et al, 2015). A similar communication pattern has been noted among HCPs working with linguistic and culturally diverse patients.…”

Section: Discussionmentioning

confidence: 99%

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Improving infectious TB education for foreign-born patients and family members

Bedingfield

Lashewicz

Fisher

et al. 2021

Health Education Journal

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Objective: In low tuberculosis (TB) incidence countries, linguistic and cultural dissonance between families experiencing infectious TB and TB health care providers is a barrier to effective communication and successful treatment. The purpose of this research was to explore infectious TB education and counselling from the perspective of patients and family members who are foreign-born. Design/Setting: One component of a multiphase, qualitative case study conducted in Calgary, a large city in western Canada. Method: Data were collected through semi-structured interviews, chart review and field notes and analysed thematically. Eight families were represented in the 6 patient and 13 family member participants who had recently experienced infectious TB. Results: Three themes were generated from the data: ‘learning about TB from many sources’, ‘reassurance and connection’ and ‘missing information’. Participants described learning about TB in different ways, feeling reassured once they knew more and sharing information with others. Overall, participants expressed satisfaction with education and counselling received. However, there were indications that communication problems had occurred. Participants asked questions during the interview, described areas of lingering confusion and shared TB-related behaviours incongruent with medical understanding. Knowledge gaps often increased isolation. Conclusion: Gaps in infectious TB education and counselling have negative impacts on patient and family member well-being. Education and counselling can be improved using multiple modes of communication, proactively addressing common misperceptions and reducing barriers to patient participation. Improvements could empower families to better manage their own experience and share accurate TB information with their communities.

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A rapid review of treatment literacy materials for tuberculosis patients

Abstract: We found few examples of comprehensive, patient-centered documents. Work is needed to achieve consensus as to the essential elements of TB treatment literacy and to create additional materials for children, patients with drug-resistant TB, and those with lower literacy levels.

Cited by 7 publications

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Patient-centered approach to the management of drug-resistant tuberculosis in France: How far off the mark are we?

Patient-centered approach to the management of drug-resistant tuberculosis in France: How far off the mark are we?

Perceptions of engagement in health care among patients with tuberculosis: a qualitative study

Improving infectious TB education for foreign-born patients and family members

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