Impact of nurse-led health education on factors affecting non-compliance to anti-tuberculosis drug regimen among pulmonary tuberculosis patients in referral hospitals, Nigeria

Onorikpori O Timothy, Ehiemere Ijeoma, Maduakolam Ijeoma O, Ilo J Ijeoma
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Abstract

Background: Pulmonary tuberculosis (PTB) remain one of the leading causes of morbidity, incapacity, and mortality around the globe. Effective TB control is hampered by the evolution of drug resistance to TB treatments. Objective: The study assessed the impact of nurse-led health education on factors affecting non-compliance to anti-tuberculosis drug regimens among pulmonary tuberculosis patients in referral hospitals, Delta state, Nigeria. Method: A quasi-experimental design involving intervention and control groups was employed, and a sample of 198 was drawn from the total population of 360 patients, using the multistage sampling technique. The study three-phased work, pre-intervention, intervention and post-intervention. A self-developed validated structured questionnaire and checklist developed by the researchers were used for data collection. The pre-post-test was administered to both the intervention and control groups while only the intervention group received health education intervention. Post-test data were collected from both groups one (1) month after the health education intervention groups. Findings were analysed using descriptive and inferential statistics. Inferential statistics were used for group comparisons and tested the impact of the intervention. Independent sample t-test and chi-square were used for group comparison at a 5% level of significance. Result: Baseline findings revealed that long duration of taking the drugs, discontinuance due to feeling of side effects and relief from ailment were identified as the most common factors affecting compliance to PTB drug regimen at the pre-intervention phase [long duration: con. (38.9%), int. (91.1%); side effects: con. (10.0%), int. (90.0%); feeling relief: con. (6.7%), int. (90.0%)] the post-intervention impact of the contributory factors to non-compliance was drastically reduced in the intervention than in the control group. Health education had a significant effect on compliance with the TB drug regimen. Conclusion: The study concluded that health education has a significant impact on factors affecting compliance. The study recommends that TB education should be adopted as part of the referral centres’ management policy.
护士主导的健康教育对尼日利亚转诊医院肺结核患者不遵守抗结核药物治疗方案的影响
背景:肺结核(PTB)仍然是全球范围内发病、丧失能力和死亡的主要原因之一。结核病治疗药物耐药性的演变阻碍了有效的结核病控制。目的:探讨护士主导的健康教育对尼日利亚三角洲州转诊医院肺结核患者抗结核药物治疗不依从性因素的影响。方法:采用准实验设计,采用干预组和对照组,从360例患者中抽取198例,采用多阶段抽样技术。本研究工作分为干预前、干预后和干预后三个阶段。数据收集采用研究者自行开发的经验证的结构化问卷和检查表。干预组和对照组均进行前-后测试,仅干预组进行健康教育干预。在健康教育干预组后1个月收集两组的测试后数据。使用描述性和推断性统计对结果进行分析。采用推理统计进行组间比较,并检验干预措施的影响。组间比较采用独立样本t检验和卡方检验,显著性水平为5%。结果:基线调查结果显示,在干预前阶段,服药时间长、因感觉副作用而停药和疾病缓解被确定为影响PTB药物治疗方案依从性的最常见因素[持续时间长:占38.9%];(91.1%);副作用:con. (10.0%), int.;(90.0%);感觉缓解:con. (6.7%), int.;(90.0%)]干预后导致不依从性因素的影响在干预后显著低于对照组。健康教育对结核病药物治疗方案的依从性有显著影响。结论:健康教育对影响依从性的因素有显著影响。该研究建议将结核病教育作为转诊中心管理政策的一部分。
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