A qualitative study of factors resulting in care delays for adults with meningitis in Zambia.
Trans R Soc Trop Med Hyg
; 116(12): 1138-1144, 2022 12 02.
Article
em En
| MEDLINE
| ID: mdl-35653707
ABSTRACT
BACKGROUND:
Meningitis causes significant mortality in regions with high comorbid HIV and TB. Improved outcomes are hindered by limited understanding of factors that delay adequate care.METHODS:
In-depth interviews of patients admitted to the University Teaching Hospital with suspected meningitis, their caregivers, doctors and nurses were conducted. Patient/caregiver interviews explored meningitis understanding, treatment prior to admission and experiences since admission. Provider interviews addressed current and prior experiences with meningitis patients and hospital barriers to care. A conceptual framework based on the Three Delays Model identified factors that delayed care.RESULTS:
Twenty-six patient/caregiver, eight doctor and eight nurse interviews occurred. Four delays were identified in-home care; transportation to a health facility; clinic/first-level hospital care; and third-level hospital. Overcrowding and costly diagnostic testing delayed outpatient care; 23% of patients began with treatment inside the home due to prior negative experiences with biomedical care. Admission occurred after multiple clinic visits, where subsequent delays occurred during testing and treatment.CONCLUSIONS:
Delays in care from home to hospital impair quality meningitis care in Zambia. Interventions to improve outcomes must address patient, community and health systems factors. Patient/caregiver education regarding signs of meningitis and indications for care-seeking are warranted to reduce treatment delays.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Aceitação pelo Paciente de Cuidados de Saúde
/
Meningite
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
Limite:
Adult
/
Humans
País/Região como assunto:
Africa
Idioma:
En
Revista:
Trans R Soc Trop Med Hyg
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos