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

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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.	全國第五次結核病流行病學抽樣調查技術指導組, 全國第五次結核病流行病學抽樣調查辦公室. 2010 年全國第五次結核病流行病學抽樣調查報告. 中國防癆雜志, 2012, 34(8): 485-508.
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8.	羅曦峰, 杜煒, 朱文忠. 某市肺結核住院患者的藥物依從性現狀及影響因素調查分析. 解放軍預防醫學雜志, 2017, 35(8): 980-982.
9.	莊榮珍, 陳榮嬌, 李小芬, 等. 肺結核患者服藥依從性及其影響因素研究. 護理實踐與研究, 2019, 16(11): 53-54.
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14.	胡雁, 王志穩. 護理研究. 5 版. 北京: 人民衛生出版社, 2017: 290-293.
15.	劉明. Colaizzi 七個步驟在現象學研究資料分析中的應用. 護理學雜志, 2019, 34(11): 90-92.
16.	許萌. 延伸護理在復治肺結核患者中的應用. 齊魯護理雜志, 2017, 23(7): 77-79.
17.	韋燕芳, 譚肖燕, 譚守勇, 等. 耐多藥與初治肺結核患者的健康教育需求比較. 廣東醫學, 2015(13): 2088-2090.
18.	雷建平. 我國結核病化療藥物不良反應的防治現狀與進展. 中國防癆雜志, 2014, 36(9): 774-782.
19.	郭少晨, 朱慧, 徐建, 等. 兩種國產抗結核固定劑量復合劑中利福平的藥代動力學和生物等效性研究. 中國防癆雜志, 2014, 36(12): 1075-1079.
20.	朱承錦. 抗結核固定劑量復合制劑(FDC)在初診肺結核患者中的應用. 牡丹江醫學院學報, 2017, 38(3): 64-65.
21.	周燕燕, 彭青, 劉冉, 等. 152 例艾滋病合并結核病患者服藥依從性及其影響因素分析. 實用預防醫學, 2019, 26(4): 389-392, 467.
22.	陳蕊明, 彭東東, 紀麗微, 等. 2011-2015 年廣東省汕頭市結核病流行病學特征及DOTS策略評價. 實用預防醫學, 2017, 24(5): 602-604.
23.	中華人民共和國衛生部. 《結核病防治管理辦法》(衛生部令第 92 號). 首都公共衛生, 2013, 35(3): 290-292.
24.	馬雪雪, 張少茹, 張天華, 等. 耐多藥結核病患者患病體驗的定性研究. 中國防癆雜志, 2017, 39(5): 529-532.
25.	周云泵, 陳嬋, 林珍. 結核病患者發生耐藥性危險因素分析及對策研究. 實用預防醫學, 2016, 23(5): 601-602.

1. 張慧民, 許光輝, 陳華, 等. 探討 2 型糖尿病合并耐藥肺結核患者的臨床護理措施和效果. 中國現代藥物應用, 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. 全國第五次結核病流行病學抽樣調查技術指導組, 全國第五次結核病流行病學抽樣調查辦公室. 2010 年全國第五次結核病流行病學抽樣調查報告. 中國防癆雜志, 2012, 34(8): 485-508.
4. 梁建琴, 武麗娟. 重視抗結核藥物的規范化應用. 中國臨床醫生雜志, 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, 黎永華. 三亞市肺結核患者治療依從性特點及其相關影響因素分析. 臨床肺科雜志, 2018, 23(8): 1502-1505.
8. 羅曦峰, 杜煒, 朱文忠. 某市肺結核住院患者的藥物依從性現狀及影響因素調查分析. 解放軍預防醫學雜志, 2017, 35(8): 980-982.
9. 莊榮珍, 陳榮嬌, 李小芬, 等. 肺結核患者服藥依從性及其影響因素研究. 護理實踐與研究, 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. 邊學峰. 中國耐多藥結核病防治體系現狀、問題與對策研究. 濟南: 山東大學, 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, 王志穩. 護理研究. 5 版. 北京: 人民衛生出版社, 2017: 290-293.
15. 劉明. Colaizzi 七個步驟在現象學研究資料分析中的應用. 護理學雜志, 2019, 34(11): 90-92.
16. 許萌. 延伸護理在復治肺結核患者中的應用. 齊魯護理雜志, 2017, 23(7): 77-79.
17. 韋燕芳, 譚肖燕, 譚守勇, 等. 耐多藥與初治肺結核患者的健康教育需求比較. 廣東醫學, 2015(13): 2088-2090.
18. 雷建平. 我國結核病化療藥物不良反應的防治現狀與進展. 中國防癆雜志, 2014, 36(9): 774-782.
19. 郭少晨, 朱慧, 徐建, 等. 兩種國產抗結核固定劑量復合劑中利福平的藥代動力學和生物等效性研究. 中國防癆雜志, 2014, 36(12): 1075-1079.
20. 朱承錦. 抗結核固定劑量復合制劑(FDC)在初診肺結核患者中的應用. 牡丹江醫學院學報, 2017, 38(3): 64-65.
21. 周燕燕, 彭青, 劉冉, 等. 152 例艾滋病合并結核病患者服藥依從性及其影響因素分析. 實用預防醫學, 2019, 26(4): 389-392, 467.
22. 陳蕊明, 彭東東, 紀麗微, 等. 2011-2015 年廣東省汕頭市結核病流行病學特征及DOTS策略評價. 實用預防醫學, 2017, 24(5): 602-604.
23. 中華人民共和國衛生部. 《結核病防治管理辦法》(衛生部令第 92 號). 首都公共衛生, 2013, 35(3): 290-292.
24. 馬雪雪, 張少茹, 張天華, 等. 耐多藥結核病患者患病體驗的定性研究. 中國防癆雜志, 2017, 39(5): 529-532.
25. 周云泵, 陳嬋, 林珍. 結核病患者發生耐藥性危險因素分析及對策研究. 實用預防醫學, 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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