Patient ervaringen met persoon-gecentreerde tuberuclose zorg.
Abstract
Introduction
WHO published the ‘EndTB strategy’ in 2015 with a key role for patient-centred tuberculosis (TB) care. Patient-centred care, and by extension person-centred care, focuses not only on the medical condition, but also on the person. The aim of this study was to explore experiences with person-centredness in TB care in the Netherlands.
Method
Qualitative research was conducted through semi-structured interviews, using an interview guide based on 8 dimensions of person-centredness by the ‘Picker Institute’. Adults who completed treatment for drug-sensitive TB were included. The transcripts were analyzed using thematic analysis.
Results
Eleven persons were interviewed. In general, participants experienced easy access to TB health advice. Some felt TB diagnosis was delayed and experienced shortages of staff and rushed appointments. TB healthcare providers were considered reliable, treatment effective and guidance by the PHS-nurse appreciated. Confirmation of cure and follow-up after completion of therapy were at times lacking. Continuity of care was perceived mostly in the outpatient setting and nursing care. Participants experienced clear information, communication and support for self-care, yet some felt insufficiently prepared for length of hospital stay. Although there was respect for some preferences, there was room for improvement for shared-decision making. Participants described their doctors and nurses as understanding, reassuring and motivating. However, during hospital stay some reported a lack of empathy and in the diagnostic phase and hospital stay they felt not always taken seriously. Side-effects were mostly managed to satisfaction and participants experienced attention to physical needs.
Conclusion
Several aspects of person-centredness in TB care were experienced. All participants appreciated the guidance by the TB nurse. Improvements might be made on access to TB care in the diagnostic phase, shared-decision making and post-TB care.