| ObjectiveTo explore a new approach for community management of tuberculosis by villuge doctors in order to establish a feasible and effective managing model in rural areas for improving the quality of TB prevention and control and reducing the hazards on the health of population caused by tuberculosis.MethodsNanhui,one of the rural areas of Shanghai, was selected for the field research. In baseline survey random sampling method was used and 1,150 permanent residents were selected to collect data on demography, TB-related knowledge, attitudes and behavior. Village doctors and community doctors were the main implementing personnals of the intervention in public education of tuberculosis intervention. Village doctors were used as the main experimental group and doctors from community health centers were used as control group for the main TB management. The experimental group and the control group randomly select five communities respectively to analyze and compare the effects of diagnosis and treatment for two groups of patients with pulmonary tuberculosis. Another 1,150 permanent residents were randomly selected after 2 years of the different interventions. Demographic information, TB-related knowledge, attitudes and behavior data were collected again for intervention evaluation.ResultsIn the study on general public, the first phase of a total of 1143 alid questionnaires were qualified. Subjectives in the survey were mainly middle-aged local residence, the majority of the subjectives were married persons. Educational status was mainly primary or junior secondary educational level. Most of subjects participated in the medical insurance of the rural cooperative medical care. The present results showed that the general public level of TB-related knowledge in general is following:most, of them were willing to participate in TB propagandistic and educational activities and willing to learn the knowledge of TB. Due to the lack of access to and read promotional materials, however, current knowledge of TB was still very limited. Village doctors in TB prevention and control work could not play an effictive role. The second phase of a total of 1102 valid questionnaire. were qualified, and the results showed that TB-related knowledge, attitudes and behavior very significantly increased or improved in both of the two groups after the two types of interventions. There were significant differences in attitude, behavior between two intervention groups but there is no significant difference in the TB-related knowledge. Doctors in rural areas have significant advantages to carry out propagandiste and educational activities, because they can do promotional activities deeply and participants can get TB-relaced propagandistic or educational materials easily, and they can get an access to a higher level of reading. In addition, the general public had more opportunities to listen to village doctors for describing the knowledge of tuberculosis and policies than community doctors group. In the study on TB patients, village doctors have greater advantages over the timely intervention, the use of standardized treatment protocols, sputum test the end of the 2th month, outcome of treatment, the following up situation of doctors, as well as propagandistic and educational ctivities for tuberculosis prevention and control, etc. Village doctors intervention group was superior to community doctors in the use of standardized treatment protocols, medical follow-up, treatment outcomes of TB, and there were statistically significant differences between two groups (P<0.05).ConclusionBoth of the village doctors and community doctors are effective in carrying out public education intervention.Village doctors can play an effective role in education and management for TB patients and may be. more.effective tp develope deeper propaganda and education of TB prevention and control in r rural areas. Village doctors would play more significant advantage in the management of rural patients with tuberculosis.Effective policy to promote the village doctors as the main mode of TB management will greatly, improve the managing effectives T TB control and reduce the hazards of tiberculosis in rura are...
|
PDF Full Text Request