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Humiliation or care? A qualitative study of patients' and health professionals' experiences with tuberculosis treatment in Norway.

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Title: Humiliation or care? A qualitative study of patients' and health professionals' experiences with tuberculosis treatment in Norway.
Authors: Sagbakken, Mette (AUTHOR), Bjune, Gunnar A. (AUTHOR), Frich, Jan C. (AUTHOR)
Source: Scandinavian Journal of Caring Sciences. Jun2012, Vol. 26 Issue 2, p313-323. 11p.
Subjects: Tuberculosis treatment, Attitude (Psychology), Community health nursing, Home nursing, Interviewing, Research methodology, Medical quality control, Medical personnel, Nurses, Patient satisfaction, Research, Sound recordings, Qualitative research, Judgment sampling, Patients' attitudes
Geographic Terms: Norway
Abstract: Scand J Caring Sci; 2012; 26; 313-323 Humiliation or care? A qualitative study of patients' and health professionals' experiences with tuberculosis treatment in Norway Aim: Directly observed treatment (DOT) has been implemented globally as a strategy in treatment of tuberculosis. Studies from high-endemic settings show that DOT involves social and economical burdens for patients, but little is known about experiences with practicing DOT in low-endemic settings. The present study explores patients' and health professionals' views and experiences with DOT in Norway. Method: In-depth interviews were conducted with 22 patients originating from Somalia and Ethiopia and with 20 health professionals. Data from the interviews were analysed using systematic text condensation. Findings: We found that there was little room for patients to negotiate whether or not to consent to the organization of treatment (DOT). Patients told that it was difficult to question the way treatment was organized, as they got the impression that there was no other way of gaining access to medication. Both patients and health professionals reported that persuasion based on authority and subtle threats was used as means to facilitate patients' acceptance of DOT. A majority of patients experienced DOT as humiliating and discriminating, while some had the experience of being cared for. Patients who attended school or had occupational obligations reported high social costs related to the treatment. Patients with positive experiences told that they had been given an opportunity to negotiate flexible treatment schedules and emphasized the importance of continuity among health professionals. Health professionals had divergent views and practices. Some argued that patients should be treated equally, while others argued for an individualized and flexible approach. Conclusion: The practice of DOT reflects societal power structures that influence the clinical interactions between health professionals and patients. To avoid experiences of disempowerment and humiliation among patients, treatment and care should be organized in a way that safeguards patients' right to consent to treatment and that allows patients to negotiate an individualized treatment schedule. [ABSTRACT FROM AUTHOR]
Copyright of Scandinavian Journal of Caring Sciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Humiliation or care? A qualitative study of patients' and health professionals' experiences with tuberculosis treatment in Norway.
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  Data: <searchLink fieldCode="AR" term="%22Sagbakken%2C+Mette%22">Sagbakken, Mette</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Bjune%2C+Gunnar+A%2E%22">Bjune, Gunnar A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Frich%2C+Jan+C%2E%22">Frich, Jan C.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Scandinavian+Journal+of+Caring+Sciences%22">Scandinavian Journal of Caring Sciences</searchLink>. Jun2012, Vol. 26 Issue 2, p313-323. 11p.
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  Data: <searchLink fieldCode="DE" term="%22Tuberculosis+treatment%22">Tuberculosis treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Attitude+%28Psychology%29%22">Attitude (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Community+health+nursing%22">Community health nursing</searchLink><br /><searchLink fieldCode="DE" term="%22Home+nursing%22">Home nursing</searchLink><br /><searchLink fieldCode="DE" term="%22Interviewing%22">Interviewing</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+quality+control%22">Medical quality control</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+personnel%22">Medical personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Nurses%22">Nurses</searchLink><br /><searchLink fieldCode="DE" term="%22Patient+satisfaction%22">Patient satisfaction</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Sound+recordings%22">Sound recordings</searchLink><br /><searchLink fieldCode="DE" term="%22Qualitative+research%22">Qualitative research</searchLink><br /><searchLink fieldCode="DE" term="%22Judgment+sampling%22">Judgment sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Patients'+attitudes%22">Patients' attitudes</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Norway%22">Norway</searchLink>
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  Label: Abstract
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  Data: Scand J Caring Sci; 2012; 26; 313-323 Humiliation or care? A qualitative study of patients' and health professionals' experiences with tuberculosis treatment in Norway Aim: Directly observed treatment (DOT) has been implemented globally as a strategy in treatment of tuberculosis. Studies from high-endemic settings show that DOT involves social and economical burdens for patients, but little is known about experiences with practicing DOT in low-endemic settings. The present study explores patients' and health professionals' views and experiences with DOT in Norway. Method: In-depth interviews were conducted with 22 patients originating from Somalia and Ethiopia and with 20 health professionals. Data from the interviews were analysed using systematic text condensation. Findings: We found that there was little room for patients to negotiate whether or not to consent to the organization of treatment (DOT). Patients told that it was difficult to question the way treatment was organized, as they got the impression that there was no other way of gaining access to medication. Both patients and health professionals reported that persuasion based on authority and subtle threats was used as means to facilitate patients' acceptance of DOT. A majority of patients experienced DOT as humiliating and discriminating, while some had the experience of being cared for. Patients who attended school or had occupational obligations reported high social costs related to the treatment. Patients with positive experiences told that they had been given an opportunity to negotiate flexible treatment schedules and emphasized the importance of continuity among health professionals. Health professionals had divergent views and practices. Some argued that patients should be treated equally, while others argued for an individualized and flexible approach. Conclusion: The practice of DOT reflects societal power structures that influence the clinical interactions between health professionals and patients. To avoid experiences of disempowerment and humiliation among patients, treatment and care should be organized in a way that safeguards patients' right to consent to treatment and that allows patients to negotiate an individualized treatment schedule. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Scandinavian Journal of Caring Sciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=75179878
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        Value: 10.1111/j.1471-6712.2011.00935.x
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        Text: English
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        PageCount: 11
        StartPage: 313
    Subjects:
      – SubjectFull: Tuberculosis treatment
        Type: general
      – SubjectFull: Attitude (Psychology)
        Type: general
      – SubjectFull: Community health nursing
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      – SubjectFull: Sound recordings
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      – SubjectFull: Norway
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      – TitleFull: Humiliation or care? A qualitative study of patients' and health professionals' experiences with tuberculosis treatment in Norway.
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              Text: Jun2012
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