伊朗患有肺结核的老年人中，家庭照顾者的相关因素与坚持服药的关系

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2024-10-22 DOI:10.1016/j.jctube.2024.100488

Somayeh Hassani , Farahnaz Mohammadi Shahboulagi , Mahshid Foroughan , Payam Tabarsi , Gholamreza Ghaedamini Harouni , Hamidreza Jamaati , Mohammad Varahram , Seyed Mohammad Seyedmehdi , Seyed Alireza Nadji

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引用次数: 0

摘要

背景和目的全球老年人结核病发病率和相关死亡率分别是非老年人的 3 倍和 6 倍。因此，能否成功治疗老年人结核病关系到所有国家的结核病控制计划。鉴于 "坚持服药 "是有效治疗的主要关键，因此必须找出与老年肺结核患者坚持服药有关的因素，并提供适当的干预措施。家庭护理人员在老年人的护理和治疗中起着关键作用，他们的特点会影响老年肺结核患者的服药依从性。本研究的目的是确定伊朗老年肺结核患者的服药依从性及其与家庭护理人员相关的因素。从德黑兰 Masih Deneshvari 医院传染病诊所的转诊患者中选取了 305 名符合纳入标准的老年肺结核患者及其家庭护理人员。对患有肺结核的老人使用了人口统计学和背景数据、12 项标准一般健康问卷、Zarit 护理者负担量表问卷和 Morisky Green Levine 用药依从性问卷。统计检验的显著性水平为 0.05。研究数据分析采用 SPSS-25 软件。研究结果在患有肺结核的老年人中，44.92%的老年人用药依从性较低，27.54%的老年人用药依从性中等，27.54%的老年人完全依从。已婚老人的服药依从性明显好于单身、鳏寡或孤独老人（P < 0.001，F = 53.192）。根据扎里特量表，一般健康状况较好（p > 0.001，r = 0.776）且无负担或负担较轻（p > 0.001，F = 357/96）的老年人的用药依从性明显更好。此外，照护者的一般特征（年龄、性别、婚姻状况、子女数量、教育程度、结核病知识、信息来源、与患者的关系、照护者人数、就业状况和经济承受能力）与老年结核病患者的服药依从性之间存在显著关系。序数逻辑回归的同步回归检验结果表明，变量对服药依从性行为的预测达到了非常可接受的水平。McFadden (0.4)、Nagelkerke (0.747) 和 Cox-Snell (0.714) 统计得出的决定系数值表明，预测变量对模型的解释力很高。因此，制定政策、提供强调家庭角色的治疗方案、在探访病人时调查护理人员的特征以及采取适当的干预措施，将对改善老年患者的服药依从性和控制结核病起到至关重要的作用。

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Relationship of family caregivers’ associated factors with medication adherence among elderly with tuberculosis in Iran

Background and Objective

The global incidence rate of tuberculosis and related death among the elderly are 3 times and 6 times more than that of non-elderly, respectively. Therefore, the successful treatment of tuberculosis in the elderly affects all national tuberculosis control programs. Given the fact that “medication adherence” is the main key to effective treatment, it is essential to identify the factors related to medication adherence in the elderly with tuberculosis and provide appropriate interventions. Family caregivers play a pivot role in the elderly care and treatment, and their characteristics can influence the medication adherence of the elderly with tuberculosis. The objective of present study was determining the medication adherence of the elderly with tuberculosis and the factors related to their family caregivers in Iran.

Method

The present study was carried out through descriptive-analytical method and convenience sampling. 305 elderly patients with tuberculosis as well as their family caregivers who met the inclusion criteria were selected from those who referred to infectious diseases clinic of Masih Deneshvari Hospital in Tehran. Demographic and background data, 12-item standard general health questionnaire, Zarit Scale of Caregiver Burden questionnaire and Morisky Green Levine Medication Adherence questionnaire were used for the elderly with tuberculosis. The significance level for statistical tests was considered 0.05. Data analysis of the study was done using SPSS-25 software. Independent t-test, One-way ANOVA, Tukey’s test, Spearman’s correlation test and ordinal logistic regression model were also used for the analytical statistics.

Findings

Out of the elderly with tuberculosis, 44.92 % had low medication adherence, 27.54 % had moderate medication adherence, and 27.54 % had full medication adherence. Medication adherence of married elderly was significantly better than single, widowed or lonely elderly (p < 0.001 and F = 53.192). The medication adherence was significantly better among the elderly whose caregivers had better general health (p > 0.001 and r = 0.776) and no burden or low burden according to Zarit scale (p > 0.001 and F = 357/96). In addition, there was a significant relationship between general characteristics of the caregivers (age, gender, marital status, number of children, education, knowledge about tuberculosis, sources of information, relativity to the patient, number of caregivers, employment status, and affordability) and the medication adherence of the elderly with tuberculosis. The results of simultaneous regression test of ordinal logistic regression showed that variables predict medication adherence behavior to a very acceptable level. The coefficient of determination values obtained from McFadden (0.4), Nagelkerke (0.747) and Cox-Snell (0.714) statistics demonstrated high explanatory power of the model by predictor variables.

Conclusion

The results of the present study suggested that the characteristics of family caregivers were associated with the medication adherence of the elderly patients. Therefore, policy making, providing treatment protocols emphasizing on the family role, investigating the characteristics of caregivers during patient visits and performing appropriate interventions will play vital roles in improving medication adherence of the elderly and controlling tuberculosis.

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.