Predictors of Screening Results for Depressive Symptoms Among Homeless Adults in Los Angeles With Latent Tuberculosis

اختصاصی از هایدی Predictors of Screening Results for Depressive Symptoms Among Homeless Adults in Los Angeles With Latent Tuberculosis دانلود با لینک مستقیم و پر سرعت .

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1School of Nursing, University of California, Los Angeles, CA
2David Geffen School of Medicine, University of California, Los Angeles, CA
3School of Public Health, University of California, Los Angeles, CA
Accepted 31 December 2004
Abstract: The purpose of this study was to examine predictors of screening
results for depressive symptoms in a Los Angeles homeless population with
latent tuberculosis (TB). Four hundred and fifteen homeless adults participating
in a nurse case managed intervention were included in this analysis.
Logistic regression results indicated that thosewho reported a physical health
limitation, multiple sex partners, daily drug use, alcohol dependence, or not
having completed high school, were more likely to screen positive. Social
support from non-drug users was protective. Given the importance of
adherence to TB treatment regimens, the high prevalence of a positive
screening for depressive symptoms in the homeless and the potential for
depression to reduce adherence rates, routine screening and treatment for
depression in high risk homeless adults being treated for TB may be
warranted. 2005 Wiley Periodicals, Inc. Res Nurs Health 28:220–229, 2005

Keywords: homelessness; depressive symptoms; perceived adherence with TB

Factors influencing health care workers’ adherence to work site tuberculosis screening and treatment policies

اختصاصی از هایدی Factors influencing health care workers’ adherence to work site tuberculosis screening and treatment policies دانلود با لینک مستقیم و پر سرعت .

Heather A. Joseph, MPH,a Robin Shrestha-Kuwahara, MPH,a Diane Lowry, MPH, MSW,a Lauren A. Lambert, MPH,a
Adelisa L. Panlilio, MD, MPH,b Beth G. Raucher, MD, MSHCM,c James M. Holcombe, MPPA,d Jan Poujade, RN, MS,e
Diane M. Rasmussen, RN,f and Maureen Wilce, MSa
Atlanta, Georgia, New York, New York, Jackson, Mississippi, Portland, Oregon, and Kansas City, Missouri
Background: Despite the known risk of tuberculosis (TB) to health care workers (HCWs), research suggests that many are not fully
adherent with local TB infection control policies. The objective of this exploratory study was to identify factors influencing HCWs’
adherence to policies for routine tuberculin skin tests (TSTs) and treatment of latent TB infection (LTBI).
Methods: Sixteen focus groups were conducted with clinical and nonclinical staff at 2 hospitals and 2 health departments.
Participants were segmented by adherence to TST or LTBI treatment policies. In-depth, qualitative analysis was conducted to
identify facilitators and barriers to adherence.
Results: Among all focus groups, common themes included the perception that the TSTwas mandatory, the belief that conducting
TSTs at the work site facilitated adherence, and a general misunderstanding about TB epidemiology and pathogenesis. Adherent
groups more commonly mentioned facilitators, such as the perception that periodic tuberculin skin testing was protective and the
employee health (EH) provision of support services. Barriers, such as the logistic difficulty in obtaining the TST, the perception that
LTBI treatment was harmful, and a distrust of EH, emerged consistently in nonadherent groups.
Conclusions: This information may be used to develop more effective interventions for promoting HCW adherence to TB
prevention policies. Informed efforts can be implemented in coordination with reevaluations of infection control and EH programs
that may be prompted by the publication of the revised TB infection control guidelines issued by the Centers for Disease Control
and Prevention in 2005. (Am J Infect Control 2004;32:456-61.)