title: HIV and tuberculosis coinfection: a qualitative study of treatment challenges faced by care providers.
abstract: METHODS
  Infectious Diseases Department, Karolinska University Hospital, Stockholm, Sweden.
  
  
  OBJECTIVE
  To understand the challenges faced by nurses and physicians in the treatment of patients co-infected with the human immunodeficiency virus (HIV) and tuberculosis (TB), with special focus on opportunities for information and communication technology.
  
  
  METHODS
  Using a qualitative study design, on-site observations and informal discussions were carried out to become acquainted with the clinical context. Seven nurses and six physicians were purposefully selected to participate in one-to-one in-depth interviews inspired by cognitive task analysis. Interviews were audio recorded and transcribed verbatim, and analysed using inductive thematic analysis.
  
  
  RESULTS
  Care providers faced challenges related to 1) the complexities inherent to TB-HIV co-treatment, 2) clinical knowledge and task standardisation, 3) care coordination and collaboration, 4) information management, and 5) engaging patients in their treatment.
  
  
  CONCLUSIONS
  Support is needed on several levels to address the emerging burden of TB-HIV coinfection in Sweden. Educational material and tools need to be further developed to support care providers in making decisions about adequate care, and to support collaborative activities and communication among patients and care providers. Information and communication technology based solutions may provide an opportunity to address some of these challenges.
authors.affiliation: Medical Management Centre, Karolinska Institutet, Stockholm, Sweden. carolina.wannheden@ki.se
authors.forename: C
authors.initials: C
authors.lastname: Wannheden
authors.forename: K
authors.initials: K
authors.lastname: Westling
authors.forename: C
authors.initials: C
authors.lastname: Savage
authors.forename: C
authors.initials: C
authors.lastname: Sandahl
authors.forename: J
authors.initials: J
authors.lastname: Ellenius
mesh_terms: D003142:Communication; D003299:Cooperative Behavior; D003657:Decision Making; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D007722:Health Knowledge, Attitudes, Practice; D006785:Hospitals, University; D006801:Humans; D007407:Interviews as Topic; D008490:Medical Informatics; D009723:Nurse-Patient Relations; D009726:Nurses / Q000458:organization & administration; D010817:Physician-Patient Relations; D010820:Physicians / Q000458:organization & administration; D013548:Sweden / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology / Q000628:therapy*