An Exploration of Indigenous Disease Conceptions, Treatment Adherence, and Localized Treatment Monitoring Intervention among Community Tuberculosis Patients in Hsiu-lin Township
Date Issued
2005
Date
2005
Author(s)
Wu, Szu-Yi
DOI
zh-TW
Abstract
Tuberculosis is a grave threat to global health, especially the emergence of TB strains resistant to multiple drugs. In response to this concern, it is most important to deal with the barriers of “adherence to treatment”. In Taiwan, DOTS (directly observed treatment, short-course) was intervened in mountains aboriginal townships in 1997. Moreover, we continue seeking the barriers of medicine taking default.
Mainly through in-depth interviewing community TB patients and local treatment observers, this research was conducted from July 2004 to May 2005 in Hsiu-lin township, Hualien County in an attempt to explore the pattern of “treatment adherence” among patients and the nature and implementation of local DOTS intervention. Three major results were derived from this ethnographic study. First, the indigenous conceptions of illness, including etiology, severity, and belief in the curability of disease, was delineated. Second, the interweaving of the daily life, illness concepts, and health status were presented. It was less likely for a patient to actively commit himself in regular drug taking if the patient was a member of lower socio-economic class, having unstable jobs and therefore without regular source of income, engaging in a lifestyle characterized by heavy drinking, and afflicted with multiple chronic disorders. Third, by articulating and comparing the perspectives of patients, public health nurses and local observers, it was able to present the accomplishment of the local observers in improving treatment adherence.
The concept of “syndemic” was used to explain the entwined phenomenon -- two or more afflictions, interacting synergistically, contributing to excess burden of disease in a population. This concept not only points out an explicit orientation of research and prevention approach, but also makes“public health”close to the context of everyday life.
Finally, it is suggested that the“local treatment observer” should be officially and permanently integrated into the system of TB prevention and control to provide sustainable and cultural sensitive services to TB patients, especially in remote areas.
Subjects
肺結核
秀林鄉肺結核患者
疾病觀
服藥行為
疾苦糾結互應
都治計畫
Tuberculosis
indigenous people
disease concept
treatment adherence
DOTS
SDGs
Type
thesis
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