Health care workers' fears associated with working in multidrug- and or extensively-resistant tuberculosis wards in South Africa

Int J Tuberc Lung Dis. 2013 Oct;17(10 Suppl 1):22-29. doi: 10.5588/ijtld.13.0109.

Abstract

Setting: Twenty-four drug-resistant tuberculosis (TB) hospitals and wards across all nine provinces of South Africa.

Objective: To assess health care workers' (HCWs') fears of working in multidrug-resistant TB (MDR-TB) or extensively drug-resistant TB (XDR-TB) wards.

Design: A cross-sectional descriptive study was conducted from June to September 2009 in 24 drug-resistant TB hospitals across South Africa. HCWs completed a self-administered questionnaire, including one open-ended question regarding personal concerns about their fear of contracting MDR- or XDR-TB. Responses were analysed by content analysis.

Results: Among the 24 hospitals, 499 HCWs were surveyed, of whom 363 (73%) responded to the open-ended question: 286 (86%) were nurses, 38 (11%) medical officers and 10 (3%) others. Six major themes regarding fears associated with the personal risk of acquiring drug-resistant TB emerged. These included the fear of 1) developing MDR- and XDR-TB, 2) the treatment course, 3) the financial implications, 4) family concerns, 5) working environment and 6) psychosocial issues.

Conclusions: These data suggest that the greatest fear of HCWs working in drug-resistant TB wards is contracting MDR- or XDR-TB and infecting others. This fear may negatively impact the provision of quality patient-centred care, and highlights the need for training of HCWs in infection control measures, and specifically on how HCWs can protect themselves and others from developing TB.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Extensively Drug-Resistant Tuberculosis / transmission*
  • Fear
  • Female
  • Health Care Surveys
  • Health Personnel / psychology*
  • Humans
  • Infectious Disease Transmission, Patient-to-Professional / prevention & control
  • Male
  • Middle Aged
  • Patient-Centered Care / standards
  • Quality of Health Care
  • South Africa
  • Surveys and Questionnaires
  • Tuberculosis, Multidrug-Resistant / transmission*
  • Young Adult