The role of trust and health literacy in nurse-delivered point-of-care STI testing for pregnant women living with HIV, Tshwane District, South Africa

Autor: Jeffrey D. Klausner, Joseph Daniels, Lindsey De Vos, Katherine Glockner, Emily Grew, Dawie Olivier, Andrew Medina-Marino
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Adult
medicine.medical_specialty
Point-of-care testing
Gonorrhea
Sexually Transmitted Diseases
Motivational interviewing
HIV Infections
Health literacy
Patient-provider communications
Trust
03 medical and health sciences
South Africa
0302 clinical medicine
Nursing
Pregnancy
Prenatal Diagnosis
Epidemiology
medicine
Sexually transmitted infections
Humans
030212 general & internal medicine
Pregnancy Complications
Infectious
030505 public health
business.industry
lcsh:Public aspects of medicine
Public health
Public Health
Environmental and Occupational Health
HIV
lcsh:RA1-1270
Patient Acceptance of Health Care
medicine.disease
Infectious Disease Transmission
Vertical
Health Literacy
Female
Pregnant Women
Biostatistics
Nurse-Patient Relations
0305 other medical science
business
Research Article
Qualitative research
Zdroj: BMC Public Health
BMC Public Health, Vol 20, Iss 1, Pp 1-9 (2020)
Popis: Background Sexually transmitted infections (STIs) during pregnancy result in neonatal morbidity and mortality, and may increase mother-to-child-transmission of HIV. Yet the World Health Organization’s current syndromic management guidelines for STIs leaves most pregnant women undiagnosed and untreated. Point-of-care (POC) diagnostic tests for STIs can drastically improve detection and treatment. Though acceptable and feasible, poor medication adherence and re-infection due to lack of partner treatment threaten the programmatic effectiveness of POC diagnostic programmes. Methods To engender patient-provider trust, and improve medication adherence and disclosure of STI status to sexual partners, we trained study nurses in compassionate care, good clinical practices and motivational interviewing. Using qualitative methods, we explored the role patient-provider communications may play in supporting treatment adherence and STI disclosure to sexual partners. Nurses were provided training in motivational interviewing, compassionate care and good clinical practices. Participants were interviewed using a semi-structured protocol, with domains including STI testing experience, patient-provider communication, and HIV and STI disclosure. Interviews were audio-recorded, transcribed and analyzed using a constant comparison approach. Results Twenty-eight participants treated for Chlamydia trachomatis (CT), Trichomonas vaginalis (TV), and/or Neisseria gonorrhea (NG) were interviewed. Participants described strong communications and trusting relationships with nurses trained in patient-centered care training and implementing POC STI diagnostic testing. However, women described a delayed trust in treatment until their symptoms resolved. Women expressed a limited recall of their exact diagnosis, which impacted their ability to fully disclose their STI status to sexual partners. Conclusions We recommend implementing patient health literacy programmes as part of POC services to support women in remembering and disclosing their specific STI diagnosis to sexual partners, which may facilitate partner treatment uptake and thus decrease the risk of re-infection.
Databáze: OpenAIRE
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