Qualitative study on influencing factors of drug compliance in patients with drug-resistant pulmonary tuberculosis_West China Medical Journal

Authors：

XI Mingxia ¹ ,  QU Jing ^1,2 , XIAO Meihui ³ , FU Manjiao ¹ , XIE Xiaohui ¹ , CAO Xiaohua ¹

1. Drug-resistant Tuberculosis Department, Changsha Central Hospital, Changsha, Hunan 410004, P. R. China;
2. School of Nursing, University of South China, Hengyang, Hunan 421001, P. R. China;
3. School of Nursing, Hunan University of Traditional Chinese Medicine, Changsha, Hunan 410208, P. R. China;

Corresponding author：

QU Jing, Email: 1079858112@qq.com

Keywords：

Drug-resistant tuberculosis; Medication compliance; Qualitative research

DOI：

10.7507/1002-0179.201912038

Video：

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Objective To explore the influencing factors of medication compliance in drug-resistant pulmonary tuberculosis patients.Methods Using phenomenological research methods, a semi-structured in-depth interview was conducted on 19 inpatients with drug-resistant pulmonary tuberculosis admitted to the Drug-resistant Tuberculosis Department of Changsha Central Hospital between April and August 2019, and the data were coded, analyzed, sorted out, summarized, and extracted.Results The influencing factors of medication compliance in patients with drug-resistant pulmonary tuberculosis could be divided into two categories: promoting factors and hindering factors. The promoting factors included the patient’s own factors (emphasis on medication therapy, desire for medication knowledge, and efforts to solve medication difficulties) and social factors (family support). The hindering factors included the patient’s own factors (lack of knowledge about tuberculosis, and severe negative emotions), drug treatment factors (fear of adverse drug reactions, and complicated medication plans), and social factors (increased financial burden).Conclusions Drug compliance of patients with drug-resistant pulmonary tuberculosis is affected by patients, family members, medical staff and social environment. Nursing staff should develop personalized drug plan to improve the patients’ drug compliance.

Citation： XI Mingxia, QU Jing, XIAO Meihui, FU Manjiao, XIE Xiaohui, CAO Xiaohua. Qualitative study on influencing factors of drug compliance in patients with drug-resistant pulmonary tuberculosis. West China Medical Journal, 2021, 36(1): 50-54. doi: 10.7507/1002-0179.201912038 Copy

1.	张慧民, 许光辉, 陈华, 等. 探讨 2 型糖尿病合并耐药肺结核患者的临床护理措施和效果. 中国现代药物应用, 2017, 11(5): 148-150.
2.	Yan LP, Qin LH, Zhang Q, et al. Transmission of extensively drug-resistant and multidrug resistant Mycobacterium tuberculosis in families identified by genotyping. Chin Med J (Engl), 2013, 126(3): 521-525.
3.	全国第五次结核病流行病学抽样调查技术指导组, 全国第五次结核病流行病学抽样调查办公室. 2010 年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8): 485-508.
4.	梁建琴, 武丽娟. 重视抗结核药物的规范化应用. 中国临床医生杂志, 2016, 44(6): 11-13.
5.	Alegria-Flores K, Weiner BJ, Wiesen CA, et al. Innovative approach to the design and evaluation of treatment adherence interventions for drug-resistant TB. Int J Tuberc Lung Dis, 2017, 21(11): 1160-1166.
6.	Okethwangu D, Birungi D, Biribawa C, et al. Multidrug-resistant tuberculosis outbreak associated with poor treatment adherence and delayed treatment: Arua District, Uganda, 2013-2017. BMC Infect Dis, 2019, 19(1): 387-397.
7.	蔡穆, 黎永华. 三亚市肺结核患者治疗依从性特点及其相关影响因素分析. 临床肺科杂志, 2018, 23(8): 1502-1505.
8.	罗曦峰, 杜炜, 朱文忠. 某市肺结核住院患者的药物依从性现状及影响因素调查分析. 解放军预防医学杂志, 2017, 35(8): 980-982.
9.	庄荣珍, 陈荣娇, 李小芬, 等. 肺结核患者服药依从性及其影响因素研究. 护理实践与研究, 2019, 16(11): 53-54.
10.	Fang XH, Shen HH, Hu WQ, et al. Prevalence of and factors influencing anti-tuberculosis treatment non-adherence among patients with pulmonary tuberculosis: a cross-sectional study in Anhui Province, eastern China. Med Sci Monit, 2019, 25(25): 1928-1935.
11.	Ndwiga JM, Kikuvi G, Omolo JO. Factors influencing knowledge on completion of treatment among TB patients under directly observed treatment strategy, in selected health facilities in Embu County, Kenya. Pan Afr Med J, 2016, 25(25): 234-238.
12.	边学峰. 中国耐多药结核病防治体系现状、问题与对策研究. 济南: 山东大学, 2011.
13.	World Health Organization. Companion handbook to the WHO guidelines for the programmatic management of drugresistant tuberculosis. Geneva: World Health Organization, 2014.
14.	胡雁, 王志稳. 护理研究. 5 版. 北京: 人民卫生出版社, 2017: 290-293.
15.	刘明. Colaizzi 七个步骤在现象学研究资料分析中的应用. 护理学杂志, 2019, 34(11): 90-92.
16.	许萌. 延伸护理在复治肺结核患者中的应用. 齐鲁护理杂志, 2017, 23(7): 77-79.
17.	韦燕芳, 谭肖燕, 谭守勇, 等. 耐多药与初治肺结核患者的健康教育需求比较. 广东医学, 2015(13): 2088-2090.
18.	雷建平. 我国结核病化疗药物不良反应的防治现状与进展. 中国防痨杂志, 2014, 36(9): 774-782.
19.	郭少晨, 朱慧, 徐建, 等. 两种国产抗结核固定剂量复合剂中利福平的药代动力学和生物等效性研究. 中国防痨杂志, 2014, 36(12): 1075-1079.
20.	朱承锦. 抗结核固定剂量复合制剂(FDC)在初诊肺结核患者中的应用. 牡丹江医学院学报, 2017, 38(3): 64-65.
21.	周燕燕, 彭青, 刘冉, 等. 152 例艾滋病合并结核病患者服药依从性及其影响因素分析. 实用预防医学, 2019, 26(4): 389-392, 467.
22.	陈蕊明, 彭东东, 纪丽微, 等. 2011-2015 年广东省汕头市结核病流行病学特征及DOTS策略评价. 实用预防医学, 2017, 24(5): 602-604.
23.	中华人民共和国卫生部. 《结核病防治管理办法》(卫生部令第 92 号). 首都公共卫生, 2013, 35(3): 290-292.
24.	马雪雪, 张少茹, 张天华, 等. 耐多药结核病患者患病体验的定性研究. 中国防痨杂志, 2017, 39(5): 529-532.
25.	周云泵, 陈婵, 林珍. 结核病患者发生耐药性危险因素分析及对策研究. 实用预防医学, 2016, 23(5): 601-602.

1. 张慧民, 许光辉, 陈华, 等. 探讨 2 型糖尿病合并耐药肺结核患者的临床护理措施和效果. 中国现代药物应用, 2017, 11(5): 148-150.
2. Yan LP, Qin LH, Zhang Q, et al. Transmission of extensively drug-resistant and multidrug resistant Mycobacterium tuberculosis in families identified by genotyping. Chin Med J (Engl), 2013, 126(3): 521-525.
3. 全国第五次结核病流行病学抽样调查技术指导组, 全国第五次结核病流行病学抽样调查办公室. 2010 年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8): 485-508.
4. 梁建琴, 武丽娟. 重视抗结核药物的规范化应用. 中国临床医生杂志, 2016, 44(6): 11-13.
5. Alegria-Flores K, Weiner BJ, Wiesen CA, et al. Innovative approach to the design and evaluation of treatment adherence interventions for drug-resistant TB. Int J Tuberc Lung Dis, 2017, 21(11): 1160-1166.
6. Okethwangu D, Birungi D, Biribawa C, et al. Multidrug-resistant tuberculosis outbreak associated with poor treatment adherence and delayed treatment: Arua District, Uganda, 2013-2017. BMC Infect Dis, 2019, 19(1): 387-397.
7. 蔡穆, 黎永华. 三亚市肺结核患者治疗依从性特点及其相关影响因素分析. 临床肺科杂志, 2018, 23(8): 1502-1505.
8. 罗曦峰, 杜炜, 朱文忠. 某市肺结核住院患者的药物依从性现状及影响因素调查分析. 解放军预防医学杂志, 2017, 35(8): 980-982.
9. 庄荣珍, 陈荣娇, 李小芬, 等. 肺结核患者服药依从性及其影响因素研究. 护理实践与研究, 2019, 16(11): 53-54.
10. Fang XH, Shen HH, Hu WQ, et al. Prevalence of and factors influencing anti-tuberculosis treatment non-adherence among patients with pulmonary tuberculosis: a cross-sectional study in Anhui Province, eastern China. Med Sci Monit, 2019, 25(25): 1928-1935.
11. Ndwiga JM, Kikuvi G, Omolo JO. Factors influencing knowledge on completion of treatment among TB patients under directly observed treatment strategy, in selected health facilities in Embu County, Kenya. Pan Afr Med J, 2016, 25(25): 234-238.
12. 边学峰. 中国耐多药结核病防治体系现状、问题与对策研究. 济南: 山东大学, 2011.
13. World Health Organization. Companion handbook to the WHO guidelines for the programmatic management of drugresistant tuberculosis. Geneva: World Health Organization, 2014.
14. 胡雁, 王志稳. 护理研究. 5 版. 北京: 人民卫生出版社, 2017: 290-293.
15. 刘明. Colaizzi 七个步骤在现象学研究资料分析中的应用. 护理学杂志, 2019, 34(11): 90-92.
16. 许萌. 延伸护理在复治肺结核患者中的应用. 齐鲁护理杂志, 2017, 23(7): 77-79.
17. 韦燕芳, 谭肖燕, 谭守勇, 等. 耐多药与初治肺结核患者的健康教育需求比较. 广东医学, 2015(13): 2088-2090.
18. 雷建平. 我国结核病化疗药物不良反应的防治现状与进展. 中国防痨杂志, 2014, 36(9): 774-782.
19. 郭少晨, 朱慧, 徐建, 等. 两种国产抗结核固定剂量复合剂中利福平的药代动力学和生物等效性研究. 中国防痨杂志, 2014, 36(12): 1075-1079.
20. 朱承锦. 抗结核固定剂量复合制剂(FDC)在初诊肺结核患者中的应用. 牡丹江医学院学报, 2017, 38(3): 64-65.
21. 周燕燕, 彭青, 刘冉, 等. 152 例艾滋病合并结核病患者服药依从性及其影响因素分析. 实用预防医学, 2019, 26(4): 389-392, 467.
22. 陈蕊明, 彭东东, 纪丽微, 等. 2011-2015 年广东省汕头市结核病流行病学特征及DOTS策略评价. 实用预防医学, 2017, 24(5): 602-604.
23. 中华人民共和国卫生部. 《结核病防治管理办法》(卫生部令第 92 号). 首都公共卫生, 2013, 35(3): 290-292.
24. 马雪雪, 张少茹, 张天华, 等. 耐多药结核病患者患病体验的定性研究. 中国防痨杂志, 2017, 39(5): 529-532.
25. 周云泵, 陈婵, 林珍. 结核病患者发生耐药性危险因素分析及对策研究. 实用预防医学, 2016, 23(5): 601-602.

West China Medical Journal

Qualitative study on influencing factors of drug compliance in patients with drug-resistant pulmonary tuberculosis

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