The Effectiveness of the Modified DOT Short Course Care Model on Patients With Tuberculosis at Outpatient Departments

• Main Authors: Men-Kung Dong, 董孟冠
• Other Authors: Wen-Yin Chang
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/25907433062241553734

碩士 === 臺北醫學大學 === 護理學研究所 === 94 === Abstract Title of Thesis: The Effectiveness of the Modified DOT Short couurse care Model on patients with Tuberculosis at Outpatient Departments Institution: Graduate Institute of Nursing, Taipei Medical University Author：Men-Kung Dong Thesis directed by：Wen-Yin Chang, Associate Professor Tuberculosis is a highly infectious disease and costly. However, under current Health care system, it is very difficult to implement Directly Observed Treatment,Short Course since it requires enormous manpower,resources, and financial investment. Therefore, the purposes of this study were to establish a Suitable DOTS for patients with tuberculosis in Taiwan, and to compare the differences in knowledge of tuberculosis, drug compliance, the percentage of discontinuity, and completion of treatment, and service satisfaction between patients with and without receiving DOTS. The design was two groups pre-and post comparison. Subjects were chosen from two regional medical teaching hospitals in central Taiwan. In order to prevent any bias resulted from communications between groups, one hospital with 619 beds was selected as experimental group, and another hospital with 595 beds as control group. For patients who were in the experimental group received the Modified DOTS care and the control group was treated with routine care. Data were collected before and after six months of intervention . The differences of the knowledge of tuberculosis, drug compliance, the percentage of discontinuity and completion of treatment, and service satisfaction between two groups were then compared. Data were processed with SPSS 10.0 and SAS for window 9.1 and analyzed using descriptive statistics, chi-square, t-test, paired t-test, and GEE model correlation. The results were shown as follows. There were 63 patients in total, with 32 from experiment group and 31 from control group. Data were collected from October of 2005 to May of 2006. Of these 63 patients, 40 were males (63.5%); 33 (52.4%) were 60 years old and above. 28 (44.4%) were only elementary graduates or below and 49 (77.8%) were married. 53 (84.1%) were living in town house and 39 (61.9%) were jobless. 46 (73.0%) were non-smoker. However, no significant differences were found between groups in the above mentioned variables (p＞.05).For the experimental group, the average scores of the tests on the knowledge of tuberculosis for before-Modified DOTS and after-Modified DOTS were 76.88 , 94.69 respectively (p＝.000). For control group, the average score was 74.19 before -Modified DOTs care and 81.29 after the treatment (p＝.001).For drug compliance and rate of completion, the results from experimental group were better than that of control group with no significant difference was found (p＞.05).For rate of discontinuity, no single case was found in the experimental group and only one (3.22%) was found in the control group.For service satisfaction, the average score for the experimental group was 52.4 out of 60 in total and 48.2 for the control group (p＝.019). The findings of this study demonstrate that the Modified DOTS care surely increase the knowledge and satisfaction for patient with tuberculosis. Therefore, it is recommended that the Modified DOTs care should be implemented in clinical settings to improve the quality of patient care. Key words: Modified DOTS, Tuberculosis, Outpatient Department, Effectiveness.