Factor Determining the Failed Treatment for Tuberculosis Patients

• Main Authors: Hu, Hsiao-Yun, 胡曉雲
• Other Authors: Tsai, Wen-Chen
• Format: Others
• Language: zh-TW
• Published: 2004
• Online Access: http://ndltd.ncl.edu.tw/handle/71096004430835039807

碩士 === 中國醫藥大學 === 醫務管理研究所 === 92 === Purpose: Tuberculosis is one of the important health issues in the world. The effects of prevention for tuberculosis were satisfied. However, the death rate of 5.81 per hundred thousand populations was still higher than the control standard rate defined by WHO that the tuberculosis death rate is less than 2 people per hundred thousand populations. Incomplete treatment is the important factor that increases the difficulty of tuberculosis’s prevention and treatment. This study would like to investigate the relative factors of failed treatment for TB patients. Method: The data were derived from CDC nationwide dataset of TB patients that registered in CDC from January to December in 2001. Proportional random sampling was applied to select TB patients. Structured questionnaires were used to interview TB patients by phone. Multiple regression analysis was conducted to explore the relative factors that influenced the patients’ satisfaction with treatment process and outcomes, and logistic regression analysis was applied to examine the factors that significantly affected tuberculosis patients. Results: The main problems for patients after taking medicine were drug’s side effect and uncomfortable. For the patients’ satisfaction with TB treatment, satisfied with treatment effect, and satisfied with physician’s manner and attitude would feel more satisfied in general. According to the logistic regression analysis, patients who had the experience of changing jobs or turnover during treatments had lower failed rates. Patients had the experience of changing hospitals during treatments, middle level education, lower family income, taking medicine irregularly, having interrupted treatment, and having great ill effects on life during treatments that would increase to have failed treatments. When patients knew the information of drug’s side effect and hadn’t stronger psychological fortification and lacked the awareness of TB, it would raise TB patients not to be cured. Conclusion and recommendation: The results showed that drug’s side effect, compliance, the awareness of TB and regular place of care were the key factors for TB patients to cure their TB disease. Based on the results, the study provides some recommendations to health policy decision makers as follows: (1) advocate the concept of going to the fixed hospitals/clinics for TB treatments; (2) encourage pharmaceutical factory to invent new TB medicine with lower side effect or shorter treatment course; (3) recommend the Bureau of National Health Insurance to modify the payment system for TB treatment; (4) reconfirm the TB dataset correctly. There are some recommendations to physicians as follows: (1) enhance the awareness of TB and treatment course to TB patients; (2) improve the communication with patients’ families and enhance family’s support; (3) implement case management program for TB patients. The recommendations to public health nurses are the following: (1) to attend in-service education about TB education; (2) increase the visits and give more concerns to TB patients; (3) enhance TB patients’ compliance.