Abstract
Abstract
Background
The directly observed treatment short-course (DOTS) is one of the most effective tuberculosis (TB) control measures worldwide. However, despite its aim of providing comprehensive and humanistic care, few studies have examined its psychological effects from the patient’s perspective. Thus, this study aimed to evaluate the psychological changes and identify associated factors among patients with TB undergoing the DOTS program in Japan.
Methods
This cross-sectional study recruited patients with TB receiving the DOTS program via 32 public health centers in four metropolitan cities in Japan. Surveys were administered to the patients and their attending public health or clinical nurses, who were responsible for their care and the DOTS program. Data were collected regarding the patients’ demographic and clinical characteristics, post-traumatic growth (using the Post-Traumatic Growth Inventory-Short Form [PTGI-SF]), and medication adherence, alongside open-ended questions, from 2014 to 2015. Additionally, the patients’ appraisal of the DOTS program’s efficacy and nurses’ assessment of the program’s practices were measured using two original questionnaires. Factors associated with post-traumatic growth were analyzed using variable estimation, correlation analysis, and logistic regression. Thematic analysis was conducted on the open-ended responses.
Results
Questionnaires were returned by 127 patients (125 valid answers); 98 (78.4%) of the respondents were men. Their mean age was 63.3 (standard deviation: 15.8) years. The mean PTGI-SF score was 21.7 (standard deviation: 11.1). The logistic regression analysis found that post-traumatic growth was significantly associated with the patients’ appraisal of the program’s efficacy (odds ratio [OR] = 1.157, 95% confidence interval [CI] = 1.026–1.304) and nurses’ assessment of the practices (OR = 1.307, 95% CI = 1.065–1.603). In the qualitative analysis, “Non-acceptance,” “Frustration,” and “Anxiety” were extracted as barriers to treatment; “Fear,” “Acquiring a partner,” “Relief,” and “Belief” were extracted as treatment drivers; and “Life changes” and “Rebuilding oneself” were extracted as treatment outcomes.
Conclusions
The DOTS program in Japan improves patients’ treatment adherence and leads to recovery and psychological growth. Even in other regions, it may be effective to incorporate this program’s practices that place importance on partnerships with patients. It is also necessary to continue refined quantitative and qualitative evaluations.
Funder
Grant-in-Aid for Young Scientists (B) from the Japan Society for the Promotion of Science
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference34 articles.
1. World Health Organization. Global tuberculosis report 2017. Geneva: WHO; 2019. p. 1–4. 22–24, 32–38, 57–64. http://www.who.int/tb/publications/global_report/en/. Accessed 25 May 2019
2. Japan Anti-Tuberculosis Association. Statistics of TB 2017. Tokyo: Japan Anti-Tuberculosis Association; 2017. p. 4–5. 26–27, 76–77, 83
3. Mori T. Reform of Japan’s NTP and its technical perspectives. Kekkaku. 2004;79(10):587–604. https://doi.org/10.11400/kekkaku1923.79.587.
4. Styblo K. Overview and epidemiologic assessment of the current global tuberculosis situation with an emphasis on control in developing countries. Rev Infect Dis. 1989;11(2):339–46.
5. World Health Organization. WHO tuberculosis programme: framework for effective tuberculosis control. Geneva: WHO; 1994. p. 1–13. http://apps.who.int/iris/bitstream/10665/58717/1/WHO_TB_94.179.pdf. Accessed 13 Feb 2018
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