Liu Kui, Zhang Mengdie, Luo Dan, Zheng Yan, Shen Zhenye, Chen Bin, Jiang Jianmin
Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
Psychol Res Behav Manag. 2023 Aug 4;16:2989-2999. doi: 10.2147/PRBM.S419906. eCollection 2023.
Pulmonary tuberculosis (PTB) is a serious infectious disease, and the factors and pathways that influence final treatment outcomes are unclear. Here, we aimed to assess the factors that influence treatment outcomes in patients with PTB using a structural equation model.
Participants completed a questionnaire covering demographics, understanding of PTB, psychological status, and history of medical treatment. Exploratory factor analysis and reliability testing were performed, and a structural equation model was constructed using the SPSS and Amos software.
A total of 251 participants were enrolled. Symptoms of depression were observed in 94.4% of participants, whereas 6% showed mild or greater anxiety. Through factor rotation, four common factors were extracted with a total variation of 66.15%. The structural equation model indicated that regular tuberculosis-related follow-up behaviour had a direct and positive effect on the final treatment outcome, with a path coefficient value of 0.20; the level of PTB understanding had a direct positive effect on the testing behaviour for PTB, with a path coefficient of 0.26; patients' psychological characteristics had a direct negative impact on regular testing behaviour, with a path coefficient of -0.13. The psychological characteristics and level of disease understanding of patients exerted indirect effects on the treatment outcome by affecting the way patients approached tuberculosis detection behaviour.
Interventions aimed at improving the treatment outcomes of patients with PTB should mainly focus on financial support and improvements in psychological status in addition to a greater understanding and knowledge of PTB. Furthermore, patients should be encouraged to undergo regular PTB testing during the follow up period, as this mediates the effect of other factors on treatment outcomes and also helps in achieving favourable treatment outcomes.
肺结核（PTB）是一种严重的传染病，影响最终治疗结果的因素和途径尚不清楚。在此，我们旨在使用结构方程模型评估影响肺结核患者治疗结果的因素。
参与者完成了一份涵盖人口统计学、对肺结核的了解、心理状态和治疗史的问卷。进行了探索性因素分析和信度测试，并使用SPSS和Amos软件构建了结构方程模型。
共招募了251名参与者。94.4%的参与者出现抑郁症状，而6%表现出轻度或更严重的焦虑。通过因素旋转，提取了四个共同因素，总方差为66.15%。结构方程模型表明，定期的肺结核相关随访行为对最终治疗结果有直接的正向影响，路径系数值为0.20；对肺结核的了解程度对肺结核检测行为有直接的正向影响，路径系数为0.26；患者的心理特征对定期检测行为有直接的负面影响，路径系数为-0.13。患者的心理特征和疾病了解程度通过影响患者对待肺结核检测行为的方式对治疗结果产生间接影响。
旨在改善肺结核患者治疗结果的干预措施除了要让患者更好地了解和认识肺结核外，还应主要关注经济支持和心理状态的改善。此外，应鼓励患者在随访期间定期进行肺结核检测，因为这可以调节其他因素对治疗结果的影响，也有助于实现良好的治疗效果。
