What affected Chinese parents' decisions about tuberculosis (TB) treatment: Implications based on a cross-sectional survey.

Tingsong Xia,Yuli Guo,Juan Chen,Jinxu Li,Jian Rui,Zixin Wang

doi:10.1371/journal.pone.0245691

Tingsong Xia, Yuli Guo + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0245691

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Abstract

ObjectiveAlthough progress has been made in tuberculosis (TB) treatment, China still remains one of the high-burden TB countries. One important reason that has not received sufficient scholarly attention is that Chinese individuals tend to underestimate the threat of TB. This contributed to the high rate of delay in seeking TB treatment and noncompliance with doctors’ regimen. Hence, this research examined how TB knowledge affected Chinese parents’ risk perceptions and their efficacy appraisal in TB treatment, and how their risk perception and efficacy appraisal affected their intentions to seek timely TB treatment for their children and adhere to doctors’ regimen.MethodsWe conducted an online cross-sectional survey with 1129 parents of children attending kindergarten, primary school, and middle school in Shajing, a region with high TB incidence in China. Perceived severity of TB threat to self and to others, perceived susceptibility, response efficacy, and self-efficacy were measured, in addition to TB knowledge and intentions to seek timely TB treatment and adhere to doctors’ regimens.ResultsOrdinal least squares regression demonstrated that TB knowledge was positively associated with perceived severity of TB threat to self, perceived severity of TB threat to others, perceived susceptibility, response efficacy, and self-efficacy, but it did not affect their medical decisions. In addition, binary logistic regression revealed that response efficacy and self-efficacy predicted both intentions positively, and perceived severity of TB threat to self only enhanced Chinese individuals’ intention to follow doctors’ regimens.ConclusionHealth education aimed at knowledge improvement may be effective in changing one’s perceptions of the given health threat but may not be effective to change their behavior. Thus, practitioners need to focus on changing Chinese parents’ perceptions of TB rather than simply improving their knowledge. Specifically, it is necessary to lower their efficacy in self-management and enhance their perceived infectiousness of TB.

Highlights

TB remains a major public health threat worldwide
Ordinal least squares regression demonstrated that TB knowledge was positively associated with perceived severity of TB threat to self, perceived severity of TB threat to others, perceived susceptibility, response efficacy, and self-efficacy, but it did not affect their medical decisions
Binary logistic regression revealed that response efficacy and selfefficacy predicted both intentions positively, and perceived severity of TB threat to self only enhanced Chinese individuals’ intention to follow doctors’ regimens

Summary

Introduction

TB remains a major public health threat worldwide. China reported the third largest number of TB patients in the world after India and Indonesia [1]. In 2019 there was an estimate of 833,000 new cases of TB in China, accounting for 8.4% of the total cases in the world [1]. As TB is more likely to break out in densely-populated environments such as schools [2], Chinese children can be vulnerable to this health threat. Two problems added to the severity of the spread of TB in China: the failure to seek timely TB treatment and comply with doctors’ regimens throughout the treatment. A meta-analysis of research on TB patients in China shows that only 47% of Chinese individuals with TB symptoms visited doctors timely and 59% adhered to doctors’ regimens throughout the process [3]

Results

Discussion

Conclusion