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

Abstract

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.

Determinants of Health Care-Seeking Behavior Among Pulmonary Tuberculosis Patients in Pontianak City, West Kalimantan, Indonesia

“…Moreover, our study found that family support was significantly associated with health-care seeking behaviour. Consistent with previous studies [19,20,21,22], family support was the patients' motivation to persist in healthseeking behaviour. Financial support from the family is one of the forms of family support that influence health center visit behaviour.…”

<p>Role of Treatment Adherence, Doctor–Patient Trust, and Communication in Predicting Treatment Effects Among Tuberculosis Patients: Difference Between Urban and Rural Areas</p>

“…37,39 Previous studies have shown that the medical staff in rural medical institutions received less medical education and limited knowledge in medical service delivery, 38 so doctors were not able to provide satisfactory health education and counseling services to patients, 40 which could lead to patients' low communication willingness, non-ideal enthusiasm and less initiative to participate in anti-TB treatment. 19,41 Further SEM results revealed that the treatment adherence of rural patients played a mediating role in the doctor- patient communication predicting the treatment effect. This finding provided a reasonable explanation for why rural TB patients were in suboptimal treatment, but meanwhile, it implied a solution to improve their treatment effect.…”

“… 17 The higher the mutual trust, the more confident the patients will be about the treatment service offered by the doctors, and the more active he/she will be to participate in the treatment. 18 , 19 Moreover, according to the medical agreement, TB patients have to go to the hospital every month for follow-up health examination and supplement drugs. If patients performed less trust in doctors, they may not take their medicine regularly, and even lose to follow-up or interrupt their treatment.…”

Influence of preferences in intervention research: A scoping review

“…The treatment selection process is collaborative, whereby healthcare providers inform people of alternative treatments or interventions for managing a health problem, discuss the benefits and risks of each intervention under consideration, explore the people's preferences for treatment, and provide the intervention of choice (Donovan et al, 2018;Sidani & Fox, 2014). Several benefits of accounting for treatment preferences have been reported in practice, including: enhanced people's experiences with healthcare, increased initiation and adherence to treatment, and improved health outcomes (Fors et al, 2018;Ren et al, 2019).…”