An Analysis of Factors Influencing the Compliance to Treatment of Pulmonary Tuberculosis Patients Through Family Resilience

Abstract

Background: Family holds an important role in the care of patient’s health against a disease or illness. The majority of pulmonary TB (tuberculosis) patients have poor social support systems and compliance. Problems with pulmonary TB patients have an impact on families and family unpreparedness, lack of family knowledge about tuberculosis, and the impact of discrimination (stigma) are some of the factors that need to be considered. The family resilience model to improve the compliance of pulmonary TB patients in carrying out treatment programs still requires further study. Research Objectives: To develop a model of family resilience as an effort to improve compliance to treatment for pulmonary TB patients. Research Methods: This study adopted a cross-sectional design. It was conducted in the work areas of Puskesmas in Surabaya City from August to December 2019. A sample of families with pulmonary TB patients containing 160 respondents was calculated using the Rule of Thumb formula, using a multistage random sampling technique. Research variables included: 1) individual factors: age, gender, education, knowledge, position of the patient in the family, personal motivation, 2) family factors: family type, family structure, family health care function, 3) social factors: social support, stigmas, 4) family stressors, including loss, illness and care, tension, 5) individual stress, including depression, anxiety, stress, 6) family stress, 7) family problem solving and coping skills, 8) family resilience, including survival, adaptation, acceptance, growing stronger, helping others, 9) individual belief, including susceptibility, severity, barriers, benefits, cues to action and self-efficacy, and 10) medication compliance included medication compliance and BTA conversion results. Data were collected using a questionnaire which was developed and analyzed using SEM-PLS. Research Results: The family resilience model as an effort to improve treatment compliance for pulmonary TB patients was a fit model with good predictive relevance (SRMR=0.053<0.081; NFI=0.919>0.90; Q2>0). Individual factors (t-stat=3.048) and family stress (t-stat=4.923) have an effect on the pulmonary TB patients. Individual stress (t-stat=2.642) and family resilience (t-stat=5.163) have an effect on individual beliefs. Patient factors (t-stat=2.429), family factors (t-stat=2.999), social factors (t-stat=2.745), and family stressors (t-stat=3.345) have an effect on family stress. Family stress affects family problem solving and coping skills (t-stat t=3.606). Problem solving ability and family coping skills affect family resilience (t-stat=2.116). Family resilience affects medication compliance (t-stat=7.407), while the patient's belief affects compliance (t-stat=2.881). Conclusions: There is better increased compliance to treatment through family resilience compared to individual beliefs of pulmonary TB patients. Family plays an important role in the care of sick family members, and one of the family functions is health care. Family as a group can cause, prevent, ignore, or remedy health problems in the group.