Investigation Of Treatment Compliance Of Patients With Pulmonary Tuberculosis At Different Stages And Influencing Factors

Objective:Through investigating the situation of treatment adherence with tuberculosis patients in different stages of home chemotherapy and the related factors influencing the treatment adherence of patients.In order to provide basis for the nursing staff to adjust the nursing intervention program, to take reasonable extension of nursing service measures, Toreduce the recurrence of tuberculosisand improve the cure rate of pulmonary tuberculosis.Methods: Choose 208 patients who have diagnosed with pulmonary tuberculosis and have started chemotherapy from January 2015 to July 2015 in tianjin a certain level of first-class hospital, Using the Morisky medication Adherence scale to investigate the patient's medication compliance.According to the China tuberculosis control program implementation guide for regular review of compliance regulation to investigate patients' compliance review. To investigate the medication and review compliance statusof patients in the end of the secondmonth, the end of the fourth and sixth month of chemotherapy treatment,Using a structured questionnaire designed by ourselves combining with qualitative research(individual in-depth interviews) to investigate the related factors influencing the compliance of the treatment. The influencing factors were investigated from four aspects: the social demographic characteristics, the knowledge of pulmonary tuberculosis, the psychological state of the patients and the social support, the types of the disease and the treatment of the disease. SPSS16.0software package was used for statistical analysis. The basic data of the patients were statistically described using the composition ratio, mean and standard deviation.Different stage characteristics of TB treatment adherence compared by chi-square test.At the same time, single factor(chi square test) and multivariate analysis(logistic regression analysis) were performed on the factors influencing the treatment compliance of the patients.Results: The survey results show that thetreatment compliance of pulmonary tuberculosis patients was difference in different stages of treatment,and the difference was statistically significant(P<0.05). Review compliance was lowest at the end of fourth months of treatment. Sixth month of medication adherence is the worst.The main factors that affect the treatment compliance in different stages are different. By multi-factor analysis,(logistic regression analysis)found that the main factors influencing the late second treatment adherence is whether knowing formal treatment time, the disease is seriously, worrying about discrimination, and the confidence for a cure. The main factors affecting the end of the fourth review compliance are cultural degree, monthly family income per capita, medical payment,whether know the regular treatment time and their attitude to treatment; The main factors influencing the 4th month medication adherence are sex, marriage, whether knowing the regular time, attitude to treatment, whether family reminds medication and disease types. The main factors influencing the sixth month review compliance are monthly family income per capita, medical payment method, and their attitude to treatment; The main factors influencing the sixth month medication adherence are gender, marriage, knowing regular treatment time or no, having any family remind medication and therapy typeThe higher educational level, health care, higher per capita income, knowing the regular treatment time, attention to disease, worrying about discrimination, having confidence to disease have a promoting effect on regular inspection behavior. Female,married, knowing the regular treatment time, attention to the disease, worrying about discrimination,having confidence to disease,family warning medication and smear positive patients and had been hospitalized have promoting effect on medication.Conclusion: Although the DOTS strategy has been fully implemented, But there are still no adherence behavior which affect the cure rate. The treatment compliance was different in different months. The compliance of the review inthe end of the secondmonth and sixth monthshould be higher than that of the end of the fourth month of treatment, This is related to the economic conditions of the patient.Medication compliance was decreased with the prolongation of treatment time, which was related to the degree of cognition and attention to the disease. Marital status,good economic conditions, good cognition, family support for tuberculosis are key factors affecting the compliance of treatment. Suggestions to strengthen health education, increase the degree of patients understanding of disease and family support.Countries should further improve the degree of remission of TB patients, improve the treatment compliance of patients, thereby improving the cure rate of pulmonary tuberculosis.