Department of Nursing, Kongju National University, Gongju, Republic of Korea.
Medicine (Baltimore). 2024 Sep 27;103(39):e39920. doi: 10.1097/MD.0000000000039920.
Tuberculosis (TB) remains a major public health challenge in South Korea which has one of the highest TB incidence rates among the Organisation for Economic Co-operation and Development (OECD) countries. Effective self-care, including medication adherence and regular hospital visits, is crucial for successful TB treatment and the prevention of drug resistance. TB self-care in South Korea is influenced by cultural, social, and systemic factors. This study aimed to systematically review and conduct a meta-analysis of factors influencing self-care among Korean patients with TB, providing evidence-based insights for developing effective self-care promotion programs.
A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on quantitative studies published since 2000 involving Korean patients with TB. Twenty studies were included in the final analysis, and 44 factors related to self-care were categorized into sociodemographic, TB-related, psychological, environmental, and educational characteristics. Effect sizes were calculated using Comprehensive Meta-Analysis (CMA) 4.0, with the assessment of heterogeneity and publication bias.
The meta-analysis ranked the effect sizes of the different characteristic categories as follows: environmental > educational > psychological. Among the individual factors, social support had the greatest influence on self-care, followed by quality of life, self-efficacy, nonfamily support, family support, and perceived health benefits. These findings underscore the critical role of sustained social support from the community, medical staff, and family in enhancing self-care among TB patients.
Effective self-care strategies for patients with TB should focus on interventions that strengthen the environmental, educational, and psychological aspects. These findings suggest that similar approaches can be applied in other countries facing comparable healthcare challenges. This study acknowledges limitations including potential publication bias and the exclusion of older studies and non-Korean patient studies, highlighting the need for further research across diverse settings and populations.
结核病(TB)仍然是韩国的一个主要公共卫生挑战,其结核病发病率在经济合作与发展组织(OECD)国家中位居前列。有效的自我护理,包括药物依从性和定期医院就诊,对于结核病治疗的成功和耐药性的预防至关重要。韩国的结核病自我护理受到文化、社会和系统因素的影响。本研究旨在系统地回顾和进行荟萃分析,以了解影响韩国结核病患者自我护理的因素,为制定有效的自我护理促进计划提供循证见解。
根据系统评价和荟萃分析的首选报告项目(PRISMA)指南,对 2000 年以来发表的涉及韩国结核病患者的定量研究进行了系统回顾和荟萃分析。共有 20 项研究纳入最终分析,将与自我护理相关的 44 个因素分为社会人口统计学、结核病相关、心理、环境和教育特征。使用综合荟萃分析(CMA)4.0 计算效应大小,并评估异质性和发表偏倚。
荟萃分析对不同特征类别的效应大小进行了排名:环境>教育>心理。在个体因素中,社会支持对自我护理的影响最大,其次是生活质量、自我效能、非家庭支持、家庭支持和感知健康益处。这些发现强调了社区、医务人员和家庭持续提供社会支持在增强结核病患者自我护理方面的重要作用。
针对结核病患者的有效自我护理策略应侧重于加强环境、教育和心理方面的干预措施。这些发现表明,在面临类似医疗保健挑战的其他国家,可以采用类似的方法。本研究承认存在局限性,包括潜在的发表偏倚以及排除了较旧的研究和非韩国患者的研究,这突显了在不同环境和人群中进行进一步研究的必要性。