ABSTRACT
Setting: The Prairie provinces of Canada. Objective: To understand how Indigenous peoples with infectious pulmonary tuberculosis living in different community settings in the Prairie provinces of Canada experience respiratory isolation. Design: Using an exploratory qualitative approach, we interviewed participants living in urban centres, non-remote reserve settings and remote and isolated reserve settings. Results: Through qualitative content analysis of 48 interviews, we determined that participants experienced feelings of confinement regardless of the community setting in which they lived. Participants also experienced family and social disconnect, but the experience was more potent for the remote and isolated reserve participants, who were required to be flown out of their home communities to receive treatment, and for those urban centre and non-remote reserve participants who lacked social connections. The roles of past experiences with sanitoria and of family in providing social support are discussed. Conclusions: The conclusions of this study focus on examining isolation policies and improving the hospital isolation experience.
Contexte : Les provinces de la Prairie au Canada.Objectif : Comprendre comment les populations indigènes atteintes de tuberculose pulmonaire contagieuse, vivant dans différents contextes communautaires dans les provinces de la Prairie au Canada, ressentent l'isolement.Schéma : En utilisant une approche exploratoire qualitative, nous nous sommes entretenus avec les participants vivant dans des centres urbains, ou dans des réserves éloignées non isolées et dans des réserves éloignées et isolées.Résultat : Une analyse qualitative du contenu des 48 entretiens nous a permis de déterminer que les participants ont eu des sentiments de confinement quel que soit le contexte communautaire dans lequel ils vivaient. Les participants ont également vécu une coupure familiale et sociale, mais l'expérience a été plus dure pour les participants des réserves éloignées et isolées qui ont été obligés de quitter leurs communautés pour recevoir leur traitement, et pour les patients des centres urbains et des réserves non éloignées qui manquaient de connections sociales. Le rôle des expériences passées avec les services de santé et avec le soutien social de la famille est discuté.Conclusions: Les conclusions se concentrent sur l'examen des politiques d'isolement et l'amélioration des expériences d'isolement à l'hôpital.
Marco de referencia: Las provincias de las Praderas del Canadá.Objetivo: Comprender de qué manera perciben el aislamiento respiratorio las poblaciones indígenas con tuberculosis pulmonar contagiosa, de diferentes entornos comunitarios en las provincias de las Praderas canadienses.Método: Mediante una estrategia exploratoria cualitativa, se entrevistaron los participantes que residían en centros urbanos, en reservas no distantes y en reservas aisladas y distantes.Resultados: Tras el análisis cualitativo de contenido de 48 entrevistas, se determinó que los participantes percibían una sensación de confinamiento, con independencia en su entorno comunitario. Asimismo, los participantes percibían desconexión familiar y social, pero la experiencia fue más intensa en los participantes de ámbitos distantes y aislados que tenían que salir de sus comunidades por vía aérea con el fin de recibir el tratamiento y en los participantes de centros urbanos y reservas no distantes que carecían de conexiones sociales. En el artículo se analiza la influencia de las experiencias pasadas con sanatorios y la función de la familia en la prestación del apoyo social.Conclusión: Las conclusiones se centran en el análisis de las políticas de aislamiento y las iniciativas de mejoramiento de la experiencia hospitalaria del aislamiento respiratorio.
ABSTRACT
BACKGROUND: Few children with obesity who are referred for weight management end up enroled in treatment. Factors enabling enrolment are poorly understood. Our purpose was to explore reasons for and facilitators of enrolment in paediatric weight management from the parental perspective. METHODS: Semi-structured interviews were conducted with parents of 10- to 17-year-olds who were referred to one of four Canadian weight management clinics and enroled in treatment. Interviews were audio-recorded and transcribed verbatim. Manifest/inductive content analysis was used to analyse the data, which included the frequency with which parents referred to reasons for and facilitators of enrolment. RESULTS: In total, 65 parents were interviewed. Most had a child with a BMI ≥95th percentile (n = 59; 91%), were mothers (n = 55; 85%) and had completed some post-secondary education (n = 43; 66%). Reasons for enrolment were related to concerns about the child, recommended care and expected benefits. Most common reasons included weight concern, weight loss expectation, lifestyle improvement, health concern and need for external support. Facilitators concerned the referral initiator, treatment motivation and barrier control. Most common facilitators included the absence of major barriers, parental control over the decision to enrol, referring physicians stressing the need for specialized care and parents' ability to overcome enrolment challenges. CONCLUSIONS: Healthcare providers might optimize enrolment in paediatric weight management by being proactive in referring families, discussing the advantages of the recommended care to meet treatment expectations and providing support to overcome enrolment barriers.
