PURPOSE: This study produced a rich description of the lived experiences of tuberculosis (TB) treatment among Mexican Americans living in the Lower Rio Grande Valley (LRGV) of Texas. DESIGN: This qualitative study used phenomenological methodology, guided by Merleau-Ponty's philosophical framework, particularly his theories on mind-body influence, fabric of relationships, importance of culture, and equilibrium. A purposive sample was recruited through TB clinics in four south Texas border counties: Hidalgo, Cameron, Starr, and Willacy, which make up the LRGV. Interviews from 18 participants-5 women and 13 men-were conducted in the participant's preferred language. Interviews were analyzed for common themes as described by Cohen Kahn and Steeves. FINDINGS: The majority of interviews were conducted in Spanish. Five themes were discovered: (a) day-to-day life during Directly Observed Therapy treatment, (b) signs and symptoms, (c) familismo, (d) living on the border, and (e) stigma. CONCLUSIONS: TB treatment can create a high level of patient burden. The participants in TB treatment in the LRGV on the Texas-Mexico border reported a high level of stigma. Due to this stigma, patients struggled to find a balance between exposure to stigma and the support from family that buoyed them through treatment. CLINICAL RELEVANCE: The findings support the importance of addressing stigma and the resulting sense of isolation in patients being treated for TB, perhaps through bolstering support from family and healthcare providers, which is relevant for public health professionals working in regions with high rates of TB.
PURPOSE: This study produced a rich description of the lived experiences of tuberculosis (TB) treatment among Mexican Americans living in the Lower Rio Grande Valley (LRGV) of Texas. DESIGN: This qualitative study used phenomenological methodology, guided by Merleau-Ponty's philosophical framework, particularly his theories on mind-body influence, fabric of relationships, importance of culture, and equilibrium. A purposive sample was recruited through TB clinics in four south Texas border counties: Hidalgo, Cameron, Starr, and Willacy, which make up the LRGV. Interviews from 18 participants-5 women and 13 men-were conducted in the participant's preferred language. Interviews were analyzed for common themes as described by Cohen Kahn and Steeves. FINDINGS: The majority of interviews were conducted in Spanish. Five themes were discovered: (a) day-to-day life during Directly Observed Therapy treatment, (b) signs and symptoms, (c) familismo, (d) living on the border, and (e) stigma. CONCLUSIONS: TB treatment can create a high level of patient burden. The participants in TB treatment in the LRGV on the Texas-Mexico border reported a high level of stigma. Due to this stigma, patients struggled to find a balance between exposure to stigma and the support from family that buoyed them through treatment. CLINICAL RELEVANCE: The findings support the importance of addressing stigma and the resulting sense of isolation in patients being treated for TB, perhaps through bolstering support from family and healthcare providers, which is relevant for public health professionals working in regions with high rates of TB.
Authors: Marc C I Lipman; Karina Kielmann; Stella Arakelyan; Aaron S Karat; Annie S K Jones; Nicole Vidal; Helen R Stagg; Marcia Darvell; Robert Horne Journal: Patient Prefer Adherence Date: 2021-09-21 Impact factor: 2.711