Effectiveness of Intensive Health Education on Tuberculosis Awareness, Attitude and Practice on Pulmonary Tuberculosis among Patients with Pulmonary Tuberculosis

Abstract

Tuberculosis is an infectious disease which spreads from one person to another which has a devastating impact on the economic well-being of the individual, their families, and the entire community. The effective engagement of all health care providers especially nursing personnel, play an important role to scale up and commensurate to their presence to achieve universal access to tuberculosis care. Majority of times, the nursing personnel were the first person to be contacted, to take care of the patients with tuberculosis. The aim of the study is to evaluate the effectiveness of intensive health education on Pulmonary tuberculosis among patients with newly diagnosed Pulmonary tuberculosis from the four primary health centres as Mettupalayam, Lawspet, Reddiarpalayam and Mudaliarpet under RNTCP (April 2017-February 2018), in Puducherry. The objectives of the study is to assess the tuberculosis awareness, attitude and practice of the subjects among the experimental and control group before and after the intervention, to evaluate the effectiveness of intensive health education and to find out the association between the pretest level of tuberculosis awareness, attitude and practice of the subjects with selected demographic variables. Pre experimental study was adopted. For the purpose of this study, a total of 126 subjects of newly diagnosed pulmonary tuberculosis were under RNTCP(October 2016 to February 2018) selected from the four primary health centres by using cluster stage sampling technique. The investigator explained the purpose of the study to the subjects. The pretest was conducted by using the interview method for all the subjects following that implementation of nursing strategies as intensive health education on health promotion and management of pulmonary tuberculosis, distribution of self-instructional module. Continuous follow up of the subjects every week till 2 months and the posttest-I was conducted by using the same questionnaire after 2 months i.e. end of the intensive phase and again posttest-II was conducted by using the same questionnaire after 6 months i.e. at the end of the continuous phase. The findings of the study as out of 126 subjects, the mean score of tuberculosis awareness score was 9.04±3.65 in the experimental group and 8.32±3.13 of them in the control group. The mean score of attitude towards tuberculosis was 28.38±4.60 and 29.72±5.05 of them in the control group. The mean level of tuberculosis awareness score in the experimental group was 9.04 during pretest and increased to 19.13 in posttest I and further increased to 21.57 in posttest II. But in the control group, the mean tuberculosis awareness score was 8.32 during the pretest and increased to 14.50 in posttest I and 14.84 in posttest II which indicated that there was an increase in the level of tuberculosis awareness score from pretest to posttest II in the experimental group which was significant at p<0.001 level. The mean attitude score in the experimental group was 28.38 during the pretest and increased to 46.80 in posttest I and 57.41 in posttest II and in the control group 29.72 during the pretest and increased to 29.19 in posttest I and 32.24 in posttest II which indicated there was increase in the level of attitude score which was statistically significant at p<0.001 level. The mean practice score in the experimental group was 13.97 during pretest and increased to 20.51 in posttest I and 24.51 in posttest II and in control group 13.51 during the pretest and increased to 18.69 in posttest I and 17.53 in posttest II. The mean values clearly indicated that there was an increase in the practice score which was statistically significant at p<0.001 level. The increased level of Knowledge, attitude and practice score which confirmed that the intervention was much effective in the experimental group when compared to the control group. The Kruskal-Wallis test revealed that there was a significant association between the tuberculosis awareness score of the subjects with selected demographic variables such as the source of information heard about DOTS was statistically significant at p<0.05 level, attitude score of the subjects with selected demographic variable as a marital status which was significant at p<0.05 level than other variables and the practice score of the subjects with gender which was highly significant at p<0.05 level. They concluded that the treatment outcome of the subjects under RNTCP was cured and the cure rate is 100% both in the experimental group and in the control group. Nursing strategies as intensive health education, self-care module along with anti tuberculosis drugs were found to be more effective in improving the tuberculosis awareness, attitude, practice of the subjects in the experimental group than the control group.