Barriers and facilitators to integrating depression care in tuberculosis services in South Asia: a multi-country qualitative study.

Autor: Todowede O; University of York, York, England, UK.; University of Nottingham, Nottingham, England, UK., Afaq S; University of York, York, England, UK. Saima.afaq@york.ac.uk.; School of Public Health, Faculty of Medicine, Imperial College London, London, England, UK. Saima.afaq@york.ac.uk.; Khyber Medical University, Peshawar, Pakistan. Saima.afaq@york.ac.uk., Adhikary A; National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India., Kanan S; ARK Foundation, Dhaka, Bangladesh., Shree V; National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India., Jennings HM; University of York, York, England, UK.; Hull York Medical School, York, England, UK., Faisal MR; University of York, York, England, UK., Nisar Z; Khyber Medical University, Peshawar, Pakistan., Khan I; Khyber Medical University, Peshawar, Pakistan., Desai G; National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India., Huque R; ARK Foundation, Dhaka, Bangladesh., Siddiqi N; University of York, York, England, UK.; Hull York Medical School, York, England, UK.; Bradford District Care NHS Foundation Trust, Bradford, England, UK.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2023 Jul 31; Vol. 23 (1), pp. 818. Date of Electronic Publication: 2023 Jul 31.
DOI: 10.1186/s12913-023-09783-z
Abstrakt: Background: Depression is common among people with tuberculosis (TB). The condition is typically unrecognised or untreated despite available and effective treatments in most low- and middle-income countries. TB services in these countries are relatively well established, offering a potential opportunity to deliver integrated depression screening and care. However, there is limited evidence on how such integration could be achieved. This study aimed to understand the barriers and facilitators to integrate depression care in TB services.
Methods: We conducted nine workshops with 76 study participants, including people with TB, their carers, and health service providers in Bangladesh, India, and Pakistan, seeking views on integrating depression care into TB clinics. We used a deductive thematic approach to analyse the translated transcripts of audio recordings, contemporaneous notes made during workshops for Bangladesh and India and workshop reports for Pakistan. Using the SURE (Supporting the Use of Research Evidence) thematic framework, we extracted and categorised barriers and facilitators into various domains.
Results: Reported barriers to integrating depression care in TB services included lack of knowledge about depression amongst patients and the staff, financial burden, and associated stigma for people with TB and their carers. Government buy-in and understanding of how to identify and screen for depression screening were potential facilitators reported. Additionally, breaking through mental health stigma and providing the additional resources required to deliver this service (human resources and consultation time) were essential for integrating depression and TB care.
Conclusions: Depression is a common condition found among people with TB, requiring early identification among people with TB. Integrating depression care into Tb services by health workers requires the availability of political support and the provision of resources.
(© 2023. The Author(s).)
Databáze: MEDLINE
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