[Increasing participation of primary care in the management of people with human immunodeficiency virus: hospital care professionals express their views]
- PMID: 24332444
- PMCID: PMC6985616
- DOI: 10.1016/j.aprim.2013.09.006
[Increasing participation of primary care in the management of people with human immunodeficiency virus: hospital care professionals express their views]
Abstract
Aim: To determine the opinions of infectious diseases professionals on the possibilities of monitoring patients with HIV in Primary Care.
Design: Qualitative study using in-depth interviews.
Location: Infectious Diseases Unit in the University Hospital "Virgen de la Victoria" in Málaga.
Participants: Health professionals with more than one year experience working in infectious diseases. A total of 25 respondents: 5 doctors, 15 nurses and 5 nursing assistants.
Method: Convenience sample. Semi-structured interviews were used that were later transcribed verbatim. Content analysis was performed according to the Taylor and Bogdan approach with computer support. Validation of information was made through additional analysis, expert participation, and feedback of part of the results to the participants.
Results: Hospital care professionals considered the disease-related complexity of HIV, treatment and social aspects that may have an effect on the organizational level of care. Professionals highlighted the benefits of specialized care, although opinions differed between doctors and nurses as regards follow up in Primary Care. Some concerns emerged about the level of training, confidentiality and workload in Primary Care, although they mentioned potential advantages related to accessibility of patients.
Conclusions: Physicians perceive difficulties in following up HIV patients in Primary Care, even for those patients with a good control of their disease. Nurses and nursing assistants are more open to this possibility due to the proximity to home and health promotion in Primary Care.
Objetivo: Conocer las opiniones de los profesionales de enfermedades infecciosas sobre las posibilidades de seguimiento del paciente con VIH en Atención Primaria (AP).
Diseño: Estudio cualitativo fenomenológico mediante entrevistas en profundidad.
Emplazamiento: Unidad de Enfermedades Infecciosas del Hospital Universitario «Virgen de la Victoria» de Málaga.
Participantes: Profesionales de la salud con más de un año de experiencia laboral en enfermedades infecciosas. Un total de 25 entrevistados: 5 médicos, 15 enfermeras y 5 auxiliares enfermería.
Método: Muestreo por conveniencia. Se realizaron entrevistas semiestructuradas que se transcribieron literalmente. Análisis de contenido según Taylor y Bogdan con soporte informático. Validación de la información mediante análisis complementarios, participación de expertos y devolución de parte de los resultados a los participantes.
Resultados: Los profesionales de AH atribuyeron características de complejidad al VIH en relación a la enfermedad, el tratamiento y sus aspectos sociales, con repercusiones sobre el nivel organizativo de la atención. Los profesionales resaltaron los beneficios de una atención especializada, aunque difieren las opiniones de facultativos y de enfermería en relación con el seguimiento en AP. Surgieron dudas sobre los niveles de formación, la gestión del secreto y la presión asistencial en este nivel, pero también se manifestaron las ventajas potenciales en cuanto a la accesibilidad de los pacientes a AP.
Conclusiones: Los facultativos perciben dificultades en el seguimiento del VIH en AP, incluso para usuarios con buen control del VIH. Enfermeras y auxiliares de enfermería se muestran más abiertos a esta posibilidad por la cercanía domiciliaria y la promoción de la salud de AP.
Keywords: Atención Primaria; Chronic illness; Confidencialidad; Confidentiality; Enfermedades crónicas; Human immunodeficiency virus; Integration; Integridad asistencial; Primary care; Virus de la inmunodeficiencia humana.
Copyright © 2013 Elsevier España, S.L. All rights reserved.
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