| Summary: | 碩士 === 國立陽明大學 === 臨床護理研究所 === 91 === The purpose of this study was to explore the efficacy of case management using the Directly Observed Treatment-Short course（DOTS strategy）to monitor the adherence of patients with tuberculosis（TB）. Factors measured included the rate of completion, cure, sputum conversion and the progression of chest X-rays, the knowledge of TB、re-admission rate、quality of life and the survival rate. A quasi-experimental design was employed with subjects chosen from a medical center in Taipei. Sampling criteria required that patients be diagnosed with pulmonary TB and without TB on any other organ, chronic liver or renal disease. Using age and gender as matching factors, 96 patients were randomly assigned to experimental groupⅠ, which was to receive DOTS strategy case management comprising of in-hospital education, directly observed daily medication use in first two months and one home visit per week. Experimental groupⅡ received case management comprising of in-hospital education and one home visit per month. The control group did not to receive any intervention. Each group included 32 subjects. All obtained data were analyzed using descriptive statistics, Chi-Square test, one-way ANOVA, the Kaplan-Meier test and the Log rank test. The results of this study showed that adherence, the rate of sputum conversion, the progression of chest X-rays, the knowledge of TB, and quality of life of the experimental groupⅠ were significantly improved compared to the experimental groupⅡ and the control group after intervention management. Although, the rate of completion and cure of the experimental groupⅠ were not significantly improved compared to the experimental groupⅡ and the control group, but it tended to meet the standard of World Health Organization. Based on these research findings, hospitals using case management with DOTS strategy can improve the quality of care in TB patients and improve the control of TB epidemic situation.
|
|---|
