The role of nurses in national TB control programs: qualitative insights from TB cohort review in Wales

Tamas D Barry^1,2, Yvonne Hester^3, Phil Pallant^4, Emma Thomas-Jones^4, Jonathan Underwood^2,5, Matthias Backer^5, Simon D Barry6

1. Division of Population Medicine, Cardiff University, Cardiff, UK
2. Division of Infection and Immunity, Cardiff University, Cardiff, UK
3. The Health Board, Cardiff and Vale University Health Board, Cardiff, UK

[email protected]

OPEN ACCESS

PUBLISHED: 31 October 2024

CITATION: BARRY, Tamas D et al. The role of nurses in national TB control programs: qualitative insights from TB Cohort Review in Wales. Medical Research Archives. Available at: <https://esmed.org/MRA/mra/article/view/6063>. 

COPYRIGHT: © 2025 European Society of Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

DOI: 10.1007/s2573-1924

ISSN 2375-1924

Abstract

Tuberculosis (TB) control in low-incidence countries has been challenged by the need to sustain work toward achieving and maintaining elimination targets. TB cases are often complex because many of those at most significant risk belong to marginalized populations who face barriers to healthcare access. These include individuals experiencing homelessness, people with substance use disorders, incarcerated individuals, and migrants or asylum seekers from high-incidence countries. Managing these cases, therefore, requires significant input from multidisciplinary teams and incurs a substantial administrative burden. This study aims to explore the experiences of nurses involved in TB control in Wales in 2012 as a systematic process for reviewing all notified cases of TB and evaluating service delivery. The study employs a mixed-methods approach and uses reflexive thematic analysis to analyze data from a questionnaire and qualitative interviews. The findings highlight the challenges and experiences of nurses in TB control, emphasizing the need for dedicated resources and support to enhance the effectiveness of TB services.

Keywords

• Tuberculosis
• TB control
• Nurses
• Healthcare access
• Wales

Introduction

Tuberculosis (TB) control in low-incidence countries has been challenged by the need to sustain work toward achieving and maintaining elimination targets. TB cases are often complex because many of those at most significant risk belong to marginalized populations who face barriers to healthcare access. These include individuals experiencing homelessness, people with substance use disorders, incarcerated individuals, and migrants or asylum seekers from high-incidence countries. Managing these cases, therefore, requires significant input from multidisciplinary teams and incurs a substantial administrative burden.

This study aims to explore the experiences of nurses involved in TB control in Wales in 2012 as a systematic process for reviewing all notified cases of TB and evaluating service delivery. The study employs a mixed-methods approach and uses reflexive thematic analysis to analyze data from a questionnaire and qualitative interviews. The findings highlight the challenges and experiences of nurses in TB control, emphasizing the need for dedicated resources and support to enhance the effectiveness of TB services.

Discussion

TB control programs in low-incidence countries have been challenged by the need to sustain work toward achieving and maintaining elimination targets. This study highlights priority action areas, focusing on regional disparities, time pressures, and the evolving role of nurses in TB care in Wales. It has implications for similar low-incidence settings.

Most respondents in this study acknowledged that TB CR had improved TB care in Wales and enhanced communication with health protection teams. The process of CR can provide a supportive learning experience. However, primary researchers’ professional relationships with study participants may have influenced responses, potentially leading to participants responding in a manner that they felt aligned with research expectations. This seems unlikely, though, as all responses were anonymous and many respondents were candid in their open-ended feedback.

Conflict of Interest Statement:

The authors declare no conflicts of interest.

Acknowledgement Statement:

We gratefully acknowledge the contributions of the nurses who participated in this research and the TB teams involved in CR across Wales. The lead author would also like to thank his PhD supervisors for their invaluable support and guidance.

References

1. Linnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M. Drivers of tuberculosis epidemic: The role of risk factors and social determinants. Soc Sci Med. 2009;68(12):2240-2246. doi:10.1016/j.socscimed.2009.03.041
2. Villar-Hernández R, Ghodousi A, Konstantynovska O, Duarte R, Lange C, Raviglione M. Tuberculosis: current challenges and beyond. Br J Disch. 2023;19(1). doi:10.1183/20734773.0166-2022
3. Wallis GK, Jekhan K, Woodhead M, Cleary P, Dee K, Farsow S, et al. Health professionals’ experiences of tuberculosis outbreak in the UK. BMJ Open. 2018;7(3):e017611. doi:10.1136/bmjopen-2017-017611
4. Facchini M, Cantoni S, Cegolon L, Filippini MT, Mainardi G, Marino AF, et al. Tuberculosis-related stigma leading to an incomplete contact investigation in a low-incidence country. Epidemiol Infect. 2015;143(13):2841-2848. doi:10.1017/S0950268814009347
5. Amuach P, Hamidah H, Annamma K, Ananth N. Effective communication between nurses and doctors: Barriers as perceived by nurses. J Nurs Care. 2018;07(03). doi:10.4172/2167-1168.1000455
6. Tabak N, Orit K. Relationship between nurses and doctors: Barriers as perceived by nurses. J Nurs Care. 2018;7(3). doi:10.4172/2167-1168.1000455

Supplementary Materials