The power of detention in migrants with MDR-TB: the challenges facing nurses providing effective person-centred care

Abstract

Tuberculosis is one of the world’s most dreaded pandemics known to mankind, resulting in approximately 1.6 million deaths in 2017. The misuse of first-line antibiotics; Isoniazid and Rifampicin has seen the surge of multidrug resistant tuberculosis (MDR-TB), with approximately 558,000 people worldwide developing resistance in 2017. The TB patient-centred care model created by the World Health Organisation (WHO, 2018), has been adapted globally. Within the model, directly observed treatment (DOT) allows individuals to obtain antibiotics outside of hospital. Despite this available method, less than half of individuals with TB were not offered DOT in the UK in 2013. Moreover, a recent paper highlighted how physicians would issue threats of detention to patients in order to ensure they would comply to treatment. The detaining of patients following a diagnosis of MDR-TB and registered nurse experience has yet to be addressed in the UK. The purpose of this research proposal is to explore how TB detention impacts nurse/patient relationships and the ability of nurses to provide person-centred care. This qualitative research will use a purposive strategy and will be conducted over a 9-month period in two health boards within Scotland: NHS Lothian and NHS Borders. Patients with MDR-TB and registered nurses will be invited from infectious diseases and respiratory wards to participate in semi-structured interviews. It is hoped that this research will help to define how both participants feel throughout this process and alter future person-centred practice and bring clinical change. Keywords: Qualitative, Tuberculosis, MDR-TB, Detention, Nurses, UK.