Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study
Background: Data about delayed tuberculosis diagnosis in Northern Russia are scarce yet such knowledge could enhance the care of tuberculosis. The Arkhangelsk region is situated in the north of Russia, where the population is more than one million residents. The aim of the study was to understand fa...
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ftoslouniv:oai:www.duo.uio.no:10852/40248 2023-05-15T15:23:28+02:00 Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study Kuznetsov, Vladimir Grjibovski, Andrej M Mariandyshev, Andrej O Johansson, Eva Enarson, Donald A Bjune, Gunnar A 2014-08-25T14:01:02Z http://hdl.handle.net/10852/40248 http://urn.nb.no/URN:NBN:no-44984 https://doi.org/10.1186/1471-2458-13-712 EN eng BioMed Central http://urn.nb.no/URN:NBN:no-44984 Kuznetsov, Vladimir . Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study. BMC Public Health. 2013, 13, 1-11 http://hdl.handle.net/10852/40248 1149173 info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=BMC Public Health&rft.volume=13&rft.spage=1&rft.date=2013 BMC Public Health 13 http://dx.doi.org/10.1186/1471-2458-13-712 URN:NBN:no-44984 Fulltext https://www.duo.uio.no/bitstream/handle/10852/40248/2/Hopelessness+as+a+basis+for+tuberculosis+diagnostic+delay+in+the+Arkhangelsk+region.+a+grounded+theory+study.pdf Attribution 2.0 Generic http://creativecommons.org/licenses/by/2.0/ CC-BY 1471-2458 Journal article Tidsskriftartikkel Peer reviewed PublishedVersion 2014 ftoslouniv https://doi.org/10.1186/1471-2458-13-712 2020-06-21T08:47:53Z Background: Data about delayed tuberculosis diagnosis in Northern Russia are scarce yet such knowledge could enhance the care of tuberculosis. The Arkhangelsk region is situated in the north of Russia, where the population is more than one million residents. The aim of the study was to understand factors influencing diagnostic delay among patients with tuberculosis in the Arkhangelsk region and to develop a theoretical model in order to explain diagnostic delay from the patients’ perspectives. Methods: Twenty-three patients who had experienced diagnostic delay of tuberculosis were interviewed in Arkhangelsk. Using a qualitative approach, we conducted focus-group discussions for data gathering using Grounded Theory with the Paradigm Model to analyse the phenomenon of diagnostic delay. Results: The study resulted in a theoretical model of the pathway of delay of tuberculosis diagnosis in the Arkhangelsk region in answer to the question: “Why and how do patients in the Arkhangelsk region delay tuberculosis diagnosis?” The model included categories of causal conditions, context and intervening conditions, action/interaction strategies, and consequences. The causal condition and main concern of the patients was that they were overpowered by hopelessness. Patients blamed policy, the administrative system, and doctors for their unfortunate life circumstances. This was accompanied by avoidance of health care, denial of their own health situations, and self-treatment. Only a deadly threat was a sufficient motivator for some patients to seek medical help. “Being overpowered by hopelessness” was identified as the core category that affected their self-esteem and influenced their entire lives, including family, work and social relations, and appeared even stronger in association with alcohol use. This category reflected the passive position of many patients in this situation, including their feelings of inability to change anything in their lives, to obtain employment, or to qualify for disability benefits. Conclusion: The main contributing factor to unsuccessful health-seeking behaviour for patients with tuberculosis was identified as “being overpowered by hopelessness.” This should be taken into consideration when creating any preventive programs and diagnostic algorithms aimed at increasing knowledge about TB, improving the health system, decreasing alcohol consumption and reducing the poverty of the people in Arkhangelsk. Article in Journal/Newspaper Arkhangelsk Universitet i Oslo: Digitale utgivelser ved UiO (DUO) BMC Public Health 13 1 |
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Universitet i Oslo: Digitale utgivelser ved UiO (DUO) |
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ftoslouniv |
language |
English |
description |
Background: Data about delayed tuberculosis diagnosis in Northern Russia are scarce yet such knowledge could enhance the care of tuberculosis. The Arkhangelsk region is situated in the north of Russia, where the population is more than one million residents. The aim of the study was to understand factors influencing diagnostic delay among patients with tuberculosis in the Arkhangelsk region and to develop a theoretical model in order to explain diagnostic delay from the patients’ perspectives. Methods: Twenty-three patients who had experienced diagnostic delay of tuberculosis were interviewed in Arkhangelsk. Using a qualitative approach, we conducted focus-group discussions for data gathering using Grounded Theory with the Paradigm Model to analyse the phenomenon of diagnostic delay. Results: The study resulted in a theoretical model of the pathway of delay of tuberculosis diagnosis in the Arkhangelsk region in answer to the question: “Why and how do patients in the Arkhangelsk region delay tuberculosis diagnosis?” The model included categories of causal conditions, context and intervening conditions, action/interaction strategies, and consequences. The causal condition and main concern of the patients was that they were overpowered by hopelessness. Patients blamed policy, the administrative system, and doctors for their unfortunate life circumstances. This was accompanied by avoidance of health care, denial of their own health situations, and self-treatment. Only a deadly threat was a sufficient motivator for some patients to seek medical help. “Being overpowered by hopelessness” was identified as the core category that affected their self-esteem and influenced their entire lives, including family, work and social relations, and appeared even stronger in association with alcohol use. This category reflected the passive position of many patients in this situation, including their feelings of inability to change anything in their lives, to obtain employment, or to qualify for disability benefits. Conclusion: The main contributing factor to unsuccessful health-seeking behaviour for patients with tuberculosis was identified as “being overpowered by hopelessness.” This should be taken into consideration when creating any preventive programs and diagnostic algorithms aimed at increasing knowledge about TB, improving the health system, decreasing alcohol consumption and reducing the poverty of the people in Arkhangelsk. |
format |
Article in Journal/Newspaper |
author |
Kuznetsov, Vladimir Grjibovski, Andrej M Mariandyshev, Andrej O Johansson, Eva Enarson, Donald A Bjune, Gunnar A |
spellingShingle |
Kuznetsov, Vladimir Grjibovski, Andrej M Mariandyshev, Andrej O Johansson, Eva Enarson, Donald A Bjune, Gunnar A Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study |
author_facet |
Kuznetsov, Vladimir Grjibovski, Andrej M Mariandyshev, Andrej O Johansson, Eva Enarson, Donald A Bjune, Gunnar A |
author_sort |
Kuznetsov, Vladimir |
title |
Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study |
title_short |
Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study |
title_full |
Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study |
title_fullStr |
Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study |
title_full_unstemmed |
Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study |
title_sort |
hopelessness as a basis for tuberculosis diagnostic delay in the arkhangelsk region: a grounded theory study |
publisher |
BioMed Central |
publishDate |
2014 |
url |
http://hdl.handle.net/10852/40248 http://urn.nb.no/URN:NBN:no-44984 https://doi.org/10.1186/1471-2458-13-712 |
genre |
Arkhangelsk |
genre_facet |
Arkhangelsk |
op_source |
1471-2458 |
op_relation |
http://urn.nb.no/URN:NBN:no-44984 Kuznetsov, Vladimir . Hopelessness as a basis for tuberculosis diagnostic delay in the Arkhangelsk region: a grounded theory study. BMC Public Health. 2013, 13, 1-11 http://hdl.handle.net/10852/40248 1149173 info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=BMC Public Health&rft.volume=13&rft.spage=1&rft.date=2013 BMC Public Health 13 http://dx.doi.org/10.1186/1471-2458-13-712 URN:NBN:no-44984 Fulltext https://www.duo.uio.no/bitstream/handle/10852/40248/2/Hopelessness+as+a+basis+for+tuberculosis+diagnostic+delay+in+the+Arkhangelsk+region.+a+grounded+theory+study.pdf |
op_rights |
Attribution 2.0 Generic http://creativecommons.org/licenses/by/2.0/ |
op_rightsnorm |
CC-BY |
op_doi |
https://doi.org/10.1186/1471-2458-13-712 |
container_title |
BMC Public Health |
container_volume |
13 |
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1 |
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1766354169346654208 |