尼泊尔甘达基省部分地区结核病患者的健康相关生活质量及其与药物依从性的相关因素。
Health related quality of life and associated factors with medication adherence among tuberculosis patients in selected districts of Gandaki Province of Nepal.
作者信息
Yadav Rajesh Kumar, Kaphle Hari Prasad, Yadav Dipendra Kumar, Marahatta Sujan Babu, Shah Naveen Prakash, Baral Sushila, Khatri Elina, Ojha Renuka
机构信息
School of Health and Allied Sciences, Pokhara University, 33700 Pokhara, Nepal.
Health Research Together Initiative (HeaRT: Initiative), 44600 Kathmandu, Nepal.
出版信息
J Clin Tuberc Other Mycobact Dis. 2021 Apr 15;23:100235. doi: 10.1016/j.jctube.2021.100235. eCollection 2021 May.
BACKGROUND
Tuberculosis is one of the significant public health problems of Nepal. Adherence to medication is very important for improving quality of life and preventing complication. Adherence to tuberculosis medications has significant economic and therapeutic consequences as non-adherence patients are at greater risk of developing complications which affect their health status and overall quality of life. The study aims to determine the factors associated with medication adherence and its effect on health related quality of life among tuberculosis patients in selected districts of Gandaki Province.
METHODS
A health facility based cross-sectional study was carried out among 180 tuberculosis patients registered under DOTS and receiving treatment more than or equal to 60 days. WHOQOL-BREF tools to assess quality of life and Morisky medication adherence scale (MMAS-8) was adopt to assess medication adherence. Data was entered in Epi-data and analysis was performed with the help of the Statistical Package for Social Science (SPSS). The odds ratio with a 95% CI was calculated and p-value of <0.05 was considered as cutoff for statistical significance.
RESULTS
A total 180 TB patients were participated in this study. Overall quality of life ranges from 10.75 to 89.25 with Mean ± SD as 55.96 ± 14.65. More than three-fourth (79.4%) respondents were adhere to medication. Medication adherence and health related quality of life was found statistically significant with relationship with health workers, favourable time at DOTS centre, absence of co-infection. Participants who were highly adhered to medication had good quality of life.
CONCLUSION
Majority of tuberculosis patients adhering to medication had good quality of life. Especial emphasis should be given to tuberculosis patients with co-infection, health workers should behave friendly and provide appropriate counselling in order to maintain the medication adherence and quality of life.
背景
结核病是尼泊尔严重的公共卫生问题之一。坚持服药对于提高生活质量和预防并发症非常重要。坚持服用抗结核药物具有重大的经济和治疗意义，因为不坚持服药的患者发生并发症的风险更高，这会影响他们的健康状况和整体生活质量。本研究旨在确定加德满都省选定地区结核病患者服药依从性的相关因素及其对健康相关生活质量的影响。
方法
对180名在直接观察下短程治疗（DOTS）项目登记且接受治疗不少于60天的结核病患者进行了一项基于医疗机构的横断面研究。采用世界卫生组织生活质量简表（WHOQOL-BREF）评估生活质量，并采用莫里isky药物依从性量表（MMAS-8）评估服药依从性。数据录入Epi-data，并借助社会科学统计软件包（SPSS）进行分析。计算95%置信区间的比值比，p值<0.05被视为具有统计学意义的临界值。
结果
共有180名结核病患者参与了本研究。总体生活质量评分范围为10.75至89.25，平均±标准差为55.96±14.65。超过四分之三（79.4%）的受访者坚持服药。发现服药依从性与健康相关生活质量与医护人员、在DOTS中心的有利就诊时间、无合并感染之间存在统计学显著关系。高度坚持服药的参与者生活质量良好。
结论
大多数坚持服药的结核病患者生活质量良好。应特别关注合并感染的结核病患者，医护人员应态度友好并提供适当的咨询，以维持服药依从性和生活质量。
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