Influence Of Social Work Intervention On Social Support For Elderly Tuberculosis Patients In Community

ObjectiveTo investigate the social support level and its influencing factors of elderly tuberculosis patients in communities of Hubei province.Meanwhile,a social work intervention implemented with the method of case work was conducted to explore its effects on the promotion of the social support level of elderly tuberculosis patients.MethodsElderly tuberculosis patients from communities in Wuhan and Enshi were randomly selected as intervention group and control group respectively with the multi-stage sampling method.The control group only received 6-month health education,and the intervention group received 6-month social work intervention,including health education,psychotherapy,family and social intervention.To assess the effectiveness of social work intervention,the social support level of patients were measured with the Social Support Rating Scale at baseline and at the first,third and sixth months during the intervention.The univariate analysis and multiple linear regression were used to analyze the influencing factors of social support,and the multilevel model were used to analyze the intervention effects on social support.Results1.A total of 61 and 122 elderly tuberculosis patients were included in the intervention group and control group,respectively.Overall,the proportions of men in the two groups were both about 60%,and the mean ages of the two groups were both close to 72 years.The education level was mainly in junior and senior high schools.There were no significant differences in other demographic characteristics between the two groups(P>0.05)2.In terms of objective support,76.5%of the elderly tuberculosis patients lived with their families,but there were also 10.%of the patients living alone or changing their residence frequently.There were only 2-3 sources of financial support and 2-4 sources of mental support for the patients,respectively.Subjective support of the patients mainly came from spouses and children.Only 41.5%of the patients had 3-5 close friends and only 40.%and 39.%of the patients could get the care from neighbors and colleagues,respectively.In terms of support utilization,only 44.3%of the patients confided to their close friends actively when in trouble.Only 40.4%of the patients asked help from family members,relatives and organizations when encountering difficulties.33.3%of the patients rarely or did not ask help from others and 79.8%of the patients occasionally or did not participate in activities3.Before the social work intervention,the mean total score of social support was 37.04,and the mean scores of its three dimensions were 8.17,22.10 and 6.77,respectively.The total social support score was affected by the chronic comorbidity(P<0.001);objective support score was affected by the educational level(P<0.05)and chronic comorbidity(P<0.05);subjective support score was affected by the gender(P<0.05),treatment stage(P<0.05)and chronic comorbidity(P<0.05);support utilization score was affected by the knowledge of tuberculosis(P<0.05)4.Before the social work intervention,the total score of social support(?group=2.25,P<0.05)and subjective support score(?group=2.01,P<0.001)were different between the two groups,and the objective support(?group=0.47>0.05)and support utilization score 32,P>0.05)were not different between the two groups.After the social work intervention,the changes of the total social support score(?time=0.24,P>0.05),objective support(?time=0.04,P>0.05),subjective support(?time=0.16,P>0.05),support utilization(?time=0.01,P>0.05)in the control group were not statistically significant.Compared with the control group,the total social support score(?group*time=0.61,P<0.01),objective support(?group*time=0.15,P<0.05),subjective support(?group*time=0.32,P<0.05),support utilization(?group*time=0.16,P<0.05)in the intervention group were significantly improved.ConclusionsThe social support level of the elderly tuberculosis patients in the community of Hubei Province is at a medium level.Their objective support level is good,but the subjective support and support utilization are insufficient.Gender,education level,chronic comorbidity,treatment stage,knowledge of tuberculosis will affect the level of social support of the patients.Compared with health education,social work intervention,including health education,psychotherapy,family and social intervention are effective and feasible in improving the social support for the elderly tuberculosis patients.