Comolet T M, Rakotomalala R, Rajaonarioa H
Direction Régionale de la Santé, Conakry, Guinea.
Int J Tuberc Lung Dis. 1998 Nov;2(11):891-7.
Patient compliance remains one of the main obstacles that need to be overcome by tuberculosis control programmes, in the developing world as well as in industrialised countries. A better understanding of the various factors accounting for treatment default could help to achieve better compliance from patients.
To increase the understanding of the determining factors of default in an urban environment where medical facilities are accessible. Different kinds of determinants were studied: objective socio-demographic factors, subjective psychological factors, attitudes and behaviour of patients in relation to chemotherapy, quality of relationships with the medical staff, knowledge and attitudes regarding tuberculosis.
Risk factors for default were assessed by a retrospective case-control study in a sample of 38 patients who had not completed treatment for pulmonary tuberculosis, compared with 111 controls who had completed treatment under comparable conditions.
Default appears to be significantly linked to transportation time, the sex of the patient, patient information and the quality of communication between patients and health workers. False addresses given by patients are both a methodological bias and a risk factor for future default.
Improved communication skills and attention from the medical staff could encourage more patients to complete their TB treatment.
在发展中国家和工业化国家，患者依从性仍然是结核病控制项目需要克服的主要障碍之一。更好地了解导致治疗中断的各种因素有助于提高患者的依从性。
在医疗设施可及的城市环境中，增进对治疗中断决定因素的理解。研究了不同类型的决定因素：客观社会人口学因素、主观心理因素、患者在化疗方面的态度和行为、与医务人员关系的质量、对结核病的知识和态度。
通过回顾性病例对照研究评估治疗中断的危险因素，研究对象为38例未完成肺结核治疗的患者，并与111例在类似条件下完成治疗的对照者进行比较。
治疗中断似乎与交通时间、患者性别、患者信息以及患者与医护人员之间的沟通质量显著相关。患者提供的虚假地址既是一种方法学偏差，也是未来治疗中断的危险因素。
提高沟通技巧以及医护人员给予更多关注，可能会促使更多患者完成结核病治疗。
