Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers

Detalhes bibliográficos
Autor(a) principal: Tavares, Ana Maria
Data de Publicação: 2019
Outros Autores: Garcia, Ana Cristina, Gama, Ana, Abecassis, Ana B., Viveiros, Miguel, Dias, Sónia
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.18/6569
Resumo: Background: Tuberculosis (TB) is still a major global health problem. The increasing number of cases observed among foreign-born populations contrasts with the decreasing trends observed in later years in some high-income countries. Healthcare providers are key interveners in the control of TB and HIV-TB infections. In this study, we aimed to explore the perspectives of healthcare providers working in primary care in Portugal about the provision of TB care for migrant patients with TB or HIV-TB co-infection. Methods: We applied a mixed-methods approach using an online survey and semi-structured interviews with primary healthcare providers. A total of 120 Portuguese healthcare providers participated in the survey, and 17 were interviewed. Survey and interview data were analysed applying descriptive statistics and thematic analysis, respectively. Results: Migrants' lack of knowledge on TB disease and its symptoms was the main reason for advanced-stage presentation of cases. Their high mobility and social isolation affect adherence to treatment. The providers also listed several barriers to migrants' access and use of TB care. The most frequently referred were limited socioeconomic resources, complex bureaucracy at the point of access and registration for healthcare services, especially for undocumented migrants, and obstacles for social protection. Providers also advocated more training initiatives on migrants' health, social and cultural contexts, on HIV and TB integrated care, and on TB scientific update for general practitioners and nurses working at primary healthcare centres. Conclusions: Future efforts should provide measures to overcome social, economic and administrative obstacles to care for TB-infected migrants, and promote regular training initiatives for national healthcare providers in order to raise awareness and facilitate better care to culturally diverse populations with TB.
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spelling Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providersTuberculosisMigrantsHealthcare ProvidersHIV-TBMixed Methods ResearchTuberculoseCuidados de SaúdeDeterminantes da Saúde e da DoençaInvestigação em Serviços de SaúdeBackground: Tuberculosis (TB) is still a major global health problem. The increasing number of cases observed among foreign-born populations contrasts with the decreasing trends observed in later years in some high-income countries. Healthcare providers are key interveners in the control of TB and HIV-TB infections. In this study, we aimed to explore the perspectives of healthcare providers working in primary care in Portugal about the provision of TB care for migrant patients with TB or HIV-TB co-infection. Methods: We applied a mixed-methods approach using an online survey and semi-structured interviews with primary healthcare providers. A total of 120 Portuguese healthcare providers participated in the survey, and 17 were interviewed. Survey and interview data were analysed applying descriptive statistics and thematic analysis, respectively. Results: Migrants' lack of knowledge on TB disease and its symptoms was the main reason for advanced-stage presentation of cases. Their high mobility and social isolation affect adherence to treatment. The providers also listed several barriers to migrants' access and use of TB care. The most frequently referred were limited socioeconomic resources, complex bureaucracy at the point of access and registration for healthcare services, especially for undocumented migrants, and obstacles for social protection. Providers also advocated more training initiatives on migrants' health, social and cultural contexts, on HIV and TB integrated care, and on TB scientific update for general practitioners and nurses working at primary healthcare centres. Conclusions: Future efforts should provide measures to overcome social, economic and administrative obstacles to care for TB-infected migrants, and promote regular training initiatives for national healthcare providers in order to raise awareness and facilitate better care to culturally diverse populations with TB.This study was funded by the Portuguese Foundation for Science and Technology (Fundação para a Ciência e a Tecnologia - FCT, www.FCT.pt), through funds to the Global Health and Tropical Medicine Research Centre (GHTM - UID/Multi/04413/2013). AMT was supported by FCT grant PD/BD/ 105916/2014. ABA was supported by the Investigador FCT programme.BMCRepositório Científico do Instituto Nacional de SaúdeTavares, Ana MariaGarcia, Ana CristinaGama, AnaAbecassis, Ana B.Viveiros, MiguelDias, Sónia2020-04-30T22:10:18Z2019-04-182019-04-18T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.18/6569engBMC Health Serv Res. 2019 Apr 18;19(1):233. doi: 10.1186/s12913-019-4050-01472-696310.1186/s12913-019-4050-0info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-07-20T15:41:27Zoai:repositorio.insa.pt:10400.18/6569Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T18:41:08.627171Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
title Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
spellingShingle Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
Tavares, Ana Maria
Tuberculosis
Migrants
Healthcare Providers
HIV-TB
Mixed Methods Research
Tuberculose
Cuidados de Saúde
Determinantes da Saúde e da Doença
Investigação em Serviços de Saúde
title_short Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
title_full Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
title_fullStr Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
title_full_unstemmed Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
title_sort Tuberculosis care for migrant patients in Portugal: a mixed methods study with primary healthcare providers
author Tavares, Ana Maria
author_facet Tavares, Ana Maria
Garcia, Ana Cristina
Gama, Ana
Abecassis, Ana B.
Viveiros, Miguel
Dias, Sónia
author_role author
author2 Garcia, Ana Cristina
Gama, Ana
Abecassis, Ana B.
Viveiros, Miguel
Dias, Sónia
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório Científico do Instituto Nacional de Saúde
dc.contributor.author.fl_str_mv Tavares, Ana Maria
Garcia, Ana Cristina
Gama, Ana
Abecassis, Ana B.
Viveiros, Miguel
Dias, Sónia
dc.subject.por.fl_str_mv Tuberculosis
Migrants
Healthcare Providers
HIV-TB
Mixed Methods Research
Tuberculose
Cuidados de Saúde
Determinantes da Saúde e da Doença
Investigação em Serviços de Saúde
topic Tuberculosis
Migrants
Healthcare Providers
HIV-TB
Mixed Methods Research
Tuberculose
Cuidados de Saúde
Determinantes da Saúde e da Doença
Investigação em Serviços de Saúde
description Background: Tuberculosis (TB) is still a major global health problem. The increasing number of cases observed among foreign-born populations contrasts with the decreasing trends observed in later years in some high-income countries. Healthcare providers are key interveners in the control of TB and HIV-TB infections. In this study, we aimed to explore the perspectives of healthcare providers working in primary care in Portugal about the provision of TB care for migrant patients with TB or HIV-TB co-infection. Methods: We applied a mixed-methods approach using an online survey and semi-structured interviews with primary healthcare providers. A total of 120 Portuguese healthcare providers participated in the survey, and 17 were interviewed. Survey and interview data were analysed applying descriptive statistics and thematic analysis, respectively. Results: Migrants' lack of knowledge on TB disease and its symptoms was the main reason for advanced-stage presentation of cases. Their high mobility and social isolation affect adherence to treatment. The providers also listed several barriers to migrants' access and use of TB care. The most frequently referred were limited socioeconomic resources, complex bureaucracy at the point of access and registration for healthcare services, especially for undocumented migrants, and obstacles for social protection. Providers also advocated more training initiatives on migrants' health, social and cultural contexts, on HIV and TB integrated care, and on TB scientific update for general practitioners and nurses working at primary healthcare centres. Conclusions: Future efforts should provide measures to overcome social, economic and administrative obstacles to care for TB-infected migrants, and promote regular training initiatives for national healthcare providers in order to raise awareness and facilitate better care to culturally diverse populations with TB.
publishDate 2019
dc.date.none.fl_str_mv 2019-04-18
2019-04-18T00:00:00Z
2020-04-30T22:10:18Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.18/6569
url http://hdl.handle.net/10400.18/6569
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv BMC Health Serv Res. 2019 Apr 18;19(1):233. doi: 10.1186/s12913-019-4050-0
1472-6963
10.1186/s12913-019-4050-0
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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