Support and Interventions by Public Health Nurses for Foreign-born TB Patients under the DOTS Program

Abstract

Background: For Japanese public health nurses, supporting foreign-born patients with tuberculosis (TB) still constitutes a challenge due to linguistic, cultural, and socio-economic barriers.

Aim: The aim of this study was to explore PHNs’ support and interventions in the Directly Observed Treatment Short course (DOTS) program for foreign-born patients with TB.

Methods: Semi-structured in-depth interviews were conducted with seven public health nurses from different public health centers who executed DOTS with foreign-born patients with TB. A qualitative approach was used to analyze the data, describing the nurses’ experiences with the support provided through DOTS.

Results: At the beginning of the treatment, the public health nurses really struggled to overcome sociocultural barriers, understand their patients irrespective of the underlying cultural differences, and liaise with medical institutions based on the networks that the nurses had built. During the treatment period, in order to prevent the patients from discontinuing the course, the nurses catered to their cultural backgrounds to ensure firm adherence and actively sought extra help by collaborating with a supporter. They aimed to bridge the gap between patients and healthcare professionals and provide a better overall environment for the patients to continue treatment. Furthermore, for future patient support, the nurses identified community resources and health needs. Throughout the DOTS program, the nurses sought to work on their mutual understanding and gain mastery in overcoming linguistic barriers.

Conclusion: Interpersonal communication, sensitivity toward patients with socioeconomic difficulties and cultural differences, and effective collaboration with other formal and informal resources contribute greatly to the successful treatment of foreign-born patients with TB.