Mexican immigrants' understanding and experience of tuberculosis infection

Abstract

The purpose of this dissertation study was two-fold; (1) to discover the health culture, or explanatory model of latent tuberculosis infection (LTBI) for Mexican immigrants at the U.S.-Mexico border who have been diagnosed with LTBI; and, (2) to identify those coercive and/or oppressive elements unique to this setting and population, embedded in power structures and worldviews that may shape both the conditions and social responses to diagnosis and treatment of LTBI. The viewpoints of nine Mexican immigrants diagnosed with LTBI and their spouses in their every day struggles within the historical, sociocultural, political, and economic context of the U.S.-Mexico border were explored to address the three research aims. This critical ethnographic study provided a full and systematic account of the popular and professional explanatory models that underpinned the Mexican immigrants' cultural construction of LTBI and preventive therapy. Informants participated in three in-depth interviews conducted primarily in their homes with a bilingual interpreter during a four-month period. Kleinman's Explanatory Model of Illness provided the conceptual underpinnings and critical theories provided the theoretical perspective for this study. Data sources included interviews, a demographic data questionnaire, participant observation, and field notes. Data analysis was directed toward the inductive generation of subcategories, categories, and domains that answered the research aims. The results of the study illuminated several points including the: (a) multiple conflicting viewpoints between the Mexican immigrants' popular explanatory model of TB and the diagnosis of LTBI; (b) powerful and dominating Mexican popular explanatory model of TB and how it influenced the informants' understanding of LTBI; (c) lack of folk knowledge and exclusive use of the formal health care system for producing household health during preventive therapy; and, (d) the macro-level social, political, economic and historical factors that influenced adherence to preventive therapy in the Mexican immigrant diagnosed with LTBI. This research has significance for nursing in three areas, it: (a) elicited the Mexican immigrants' popular explanatory model of TB; (b) identified points of departure with the U.S. professional explanatory model of TB and LTBI; and (c) provided essential information that the immigrants' used to inform treatment decisions for LTBI.