Effectiveness of a community health worker (CHW) training in monitoring and care of patients with chronic obstructive pulmonary disease (COPD) in rural Gujarat, India.

Autor: Gupta AV; K M Patel Institute of Physiotherapy, Karamsad, Anand, Gujarat, India., Phatak AG; Central Research Services, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India., Patel MU; K M Patel Institute of Physiotherapy, Karamsad, Anand, Gujarat, India., Das N; Community Medicine, Pramukhswami Medical College, Karamsad, Anand, Gujarat, India., Vaghela NP; K M Patel Institute of Physiotherapy, Karamsad, Anand, Gujarat, India., Prakash H; K M Patel Institute of Physiotherapy, Karamsad, Anand, Gujarat, India., Raithatha SJ; Community Medicine and Extension Programmes Department, H M Patel Centre for Medical Care and Education, Karamsad, Anand, Gujarat, India.
Jazyk: angličtina
Zdroj: Journal of family medicine and primary care [J Family Med Prim Care] 2020 Apr 30; Vol. 9 (4), pp. 1910-1914. Date of Electronic Publication: 2020 Apr 30 (Print Publication: 2020).
DOI: 10.4103/jfmpc.jfmpc_1193_19
Abstrakt: Context: Chronic obstructive pulmonary disease (COPD) is the second leading contributor to the disease burden of India. The current COPD burden cannot be managed effectively just through a physician-based approach. In a primary care setting, community health workers (CHWs) can play an effective role in making COPD care accessible and effective.
Aim: Findings of an assessment of a training program for CHWs on COPD have been reported here. Methods: 90 CHWs working as a part of a noncommunicable disease prevention and care program in a rural primary care setting were exposed to a series of five training sessions. The sessions were designed and administered jointly by a team of public health experts and physiotherapists in the year 2017-18. Topics covered were basic clinical aspects of COPD, monitoring a patient with COPD, and basic aspects of pulmonary rehabilitation. The assessment comprised 12 MCQs and short questions, 7 video exercises, 2 case vignettes, and 5 skill assessments through objectively structured clinical examination (OSCE).
Statistical Analysis: Mean percentage scores were calculated for each domain of assessment to make it comparable.
Results: 70 CHWs with a mean age of 42.2 years completed all the training and underwent the assessment. Mean percentage score (SD) for knowledge was 62% (16.3). In OSCE assessment, scores were best in sputum clearance technique demonstration (92.1%) and the least in dyspnea relieving positions (59.2%). The CHWs had difficulties in identifying signs of respiratory distress (score - 55.1%). No statistically significant association was observed between performance scores and their sociodemographic profile.
Conclusion: The results were encouraging and the program may be pilot tested in a government setting particularly using the health and wellness centers (HWC) platform.
Competing Interests: There are no conflicts of interest.
(Copyright: © 2020 Journal of Family Medicine and Primary Care.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje