Abstract
BackgroundTuberculosis (TB) is one of the top 10 causes of death in the world. Since Directly Observed Therapy (DOT) as a core strategy for the global TB control are not applicable to all types of TB patients, and self-management of TB patients (SMTP) as a patient-centered supervision type is a supplement to DOT and can improve TB case management. However, the factors related to SMTP are complex and need more study. This study aimed at identifying the determinants of SMTP and examining the direct/indirect effects of these determinants.MethodsThe purposive sampling technique was used to select study sites and participants were recruited from the study sites by the consecutive sampling method. The PRECEDE model was used as the framework to analyze the determinants of SMTP. The responses of TB patients were acquired via a questionnaire survey for data collection. A Pearson correlation analysis was used to define the relationship between the predisposing, enabling, reinforcing factors with SMTP behaviors. A regression-based path analysis was used to determine the action paths of the predisposing, enabling, and reinforcing factors on SMTP behaviors.ResultsThe predisposing (TB knowledge), enabling [health education and healthcare workers (HCWs) support], reinforcing factors (family support) had significant positive correlations with SMTP behaviors (P < 0.05). The predisposing, enabling, reinforcing factors were positively correlated with each other (r = 0.123‒0.918, P < 0.05), except for family support and HCWs support. The predisposing factors (TB knowledge, β = 0.330) and the enabling factors (HCWs support, β = 0.437) had direct effects on SMTP behaviors. The enabling factors (health education and HCWs support) and the reinforcing factors (family support) had indirect effects on SMTP behaviors.ConclusionsThis study revealed the effects and action path of TB knowledge, health education, HCWs support, and family support on SMTP behaviors via a path analysis. Assessing patient’s needs for SMTP along with promoting effective TB health education and providing firm support from HCWs and family members are potential strategies to promote SMTP behaviors.Graphic abstract
Highlights
Tuberculosis (TB) is one of the top 10 causes of death in the world
According to the ranking of the TB epidemic situation in the districts and counties of Chongqing and Guizhou in 2017, with specific factors such as geographical location and economic status comprehensively considered, a total of 12 districts/counties were selected as the study sites for this study, and 71 Primary Health Care sectors, including community health service centers (CHCs) and township hospital centers (THCs) in selected districts/counties were included in this study
At step 10, the total effect of the reinforcing factors in the prediction of self-management of TB patients (SMTP) behaviors was significant (β = 0.118). These results indicated that the reinforcing factors have no direct effect on SMTP behaviors and can have indirect effects on SMTP behaviors through the predisposing factors (TB knowledge)
Summary
Since Directly Observed Therapy (DOT) as a core strategy for the global TB control are not applicable to all types of TB patients, and self-management of TB patients (SMTP) as a patient-centered supervision type is a supplement to DOT and can improve TB case management. Tuberculosis (TB) is caused by the bacillus Mycobacterium tuberculosis, is one of the most ancient infectious diseases of mankind. It is the most deadly infections disease and one of the top 10 leading causes of death [1]. Li et al Infect Dis Poverty (2021) 10:103 an estimated 10.0 million new cases of TB and 1.4 million TB-caused deaths worldwide [1]. Though the global commitments and strategies in the fight against TB were intensified, the number of TB cases worldwide has still been declining very slowly in recent years [1]
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