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題名:肺結核病患未完成治療原因探討
書刊名:臺灣公共衛生雜誌
作者:胡曉雲蔡文正龔佩珍
作者(外文):Hu, Hsiao-yunTsai, Wen-chenKung, Pei-tseng
出版日期:2005
卷期:24:4
頁次:頁348-359
主題關鍵詞:肺結核未完治療完治率結核病Pumonary tuberculosisFailure rateCure rateTuberculosis
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(13) 博士論文(2) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:13
  • 共同引用共同引用:9
  • 點閱點閱:56
     目標:結核病是全球重要的健康問題之一,未完成治療不但是影響國內結核病防治的重大因素,同時也增加防疫與治療上的困難,因此本研究希望藉由全國性之調查,了解造成肺結核患者未完成治療之因素。 方法:本研究對象為疾病管制局2001年1∼12月所登錄全國之肺結核病患,針對完治及未完治病患,利用分層隨機比例抽樣,以電話訪問方式進行問卷調查。並利用羅吉斯迴歸分析探討影響肺結核患者是否完成肺結核治療之相關因素。 結果:在治療的過程中以服藥後有副作用(30.7%)及感覺很不舒服(25.8%)為困擾及造成肺結核病患未完治之主要問題。曾因為罹患肺結核而更換工作或離職者其未完治機率較低(勝算比0.46);病患治療過程中曾中斷服藥者其未完治機率顯著較高(勝算比4.37)。另外,治療期間有更換過醫院、中等教育程度、家庭收入低、未規則服藥、治療過程對生活相當有影響者亦有較高的機率未完成治療。然病患越瞭解服用藥物後的副作用越有未完成治療的傾向,當病患瞭解肺結核傳染途徑及治療時間時則其未完治機率較低。 結論:由本研究結果可知藥物副作用、服藥遵從性、對肺結核疾病的認知及是否有固定就醫場所都是影響肺結核病患是否完治的重要關鍵因素。因此,需加強病患對疾病與療程的認知,同時醫療院所實施個案管理是降低肺結核病患未完治率的首要任務。
     Objectives: Incomplete treatment is an important factor, which contributes to the difficulty in the prevention and treatment of tuberculosis (TB). This study investigated the factors associated with treatment failure in TB patients. Methods: The data were derived from the Center for Disease Control (CDC) nationwide dataset of pulmonary TB patients registered in 2001. TB patients were selected by proportional random sampling. Structured questionnaires were used to interview TB patients by phone, and logistic regression analysis was used to examine the factors that affected treatment outcome. Results: TB patients reported that side effects (30.7%) and general discomfort (25.8%) were the main problems encountered after taking medication. Treatment failure rates were lower in patients who changed jobs during treatment (OR 0.46) and higher in patients who interrupted treatment (OR 4.37). Other factors contributing to treatment failure included changing hospitals during treatment, having a mid-level education, having lower household income, taking medication irregularly, and the negative effect TB has on quality of life. In addition, patients who knew about the drugs' side effects had higher treatment failure rates; furthermore, patients who had knowledge about the transmission route of TB and the time needed for successful treatment had lower rates of treatment failure. Conclusion: Side effects of medication, compliance, the awareness of TB, and regular place of care were the key factors for successful TB treatment. Based on the results, we conclude that patients need to be made aware of TB and the appropriate treatment courses. The implementation of a case management program may increase the rate of successful treatment.
期刊論文
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2.李培元(19921200)。九十年代結核病的藥物治療。內科學誌,3(4),265-269。  延伸查詢new window
3.Campbell, A. H.、Guilfoyle, P.(1970)。Pulmonary tuberculosis, isoniazid and cancer。Brit J Dis Chest,64,141-149。  new window
4.王妙(19840400)。北區七縣市結核病開放性病患未達完成治療原因之探討。公共衛生,11(1),93-99。  延伸查詢new window
5.Wilkinson, D.、Davis, G. R.、Connolly, C.(1996)。Directly observed therapy for tuberculosis in rural South Africa。Am J Pub Health,86,1094-1097。  new window
6.Davies, P. D.(2003)。The role of DOTS in tuberculosis treatment and control。Am J Respir Med,2,203-209。  new window
7.WHO(2004)。Tuberculosis Fact Sheet。WER,79,125-128。  new window
8.Mukherjee, J. S.、Rich, M. L.、Socci, A. R.、Joseph, J. K.、Viru, F. A.、Shin, S. S.(2004)。Programmes and principles in treatment of multidrug-resistant tuberculosis。Lancet,363,474-478。  new window
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10.廖麗娟(19890700)。臺灣省肺結核病人就診延誤之研究。公共衛生,16(2),166-178。  延伸查詢new window
11.余明治、黃菊、何秀英、江振源、索任、林道平(20000300)。直接觀察短程治療法對山地鄉肺結核病人治療的影響。胸腔醫學,15(1),22-28。  延伸查詢new window
12.Westaway, M. S.(1989)。Knowledge, beliefs and feelings about tuberculosis。Health Educ Res,4,205-211。  new window
13.Dunn, S. M.、Beeney, L. J.、Hoskins, P. L.、Turtle, J. R.(1990)。Knowledge and attitude change as predictors of metabolic improvement in diabetes education。Social Science & Medicine,31(10),1135-1141。  new window
14.Scullion, J.(2003)。Tuberculosis and older people。Nursing Older People,15(3),23-28。  new window
15.李龍騰(19920900)。Morbidity and Mortality Trends of Pulmonary Tuberculosis in Taiwan。臺灣醫學會雜誌,91(9),867-872。  new window
16.林獻鋒、賴世偉、張靖梅、劉秋松(20020400)。肺結核。基層醫學,17(4),78-84。  延伸查詢new window
17.何延鑫(19980900)。運用護理指導增進門診結核病個案服藥之遵從行為。榮總護理,15(3),315-320。new window  延伸查詢new window
18.Suárez, P. G.、Floyd, K.、Portocarrero, J.(2002)。Feasibility and cost-effectiveness of standardised second-line drug treatment for chronic tuberculosis patients: a national cohort study in Peru。Lancet,359,1980-1989。  new window
19.謝家如、林麗嬋(20030400)。結核病與個案管理模式。護理雜誌,50(2),77-81。new window  延伸查詢new window
20.Chaulk, C. P.、Pope, D. S.(1997)。The Baltimore city health department program of directly observed therapy for tuberculosis。Clinics in Chest Medicine,18(1),149-154。  new window
21.江振源(20001200)。DOTS--結核防治之最佳策略。胸腔醫學,15(4),172-177。  延伸查詢new window
研究報告
1.行政院衛生署疾病管制局(2004)。傳染病統計分析。  延伸查詢new window
2.楊文達(2001)。台灣中區影響結核病個案復發治療之相關因子探討 (計畫編號:DOH90-DC-1011)。  延伸查詢new window
3.龔佩珍、蔡文正(2003)。影響結核病個案完治關鍵因素之研究 (計畫編號:DOH92-DC-1109)。  延伸查詢new window
4.蔡文正、龔佩珍、江自得(2002)。全民健康保險肺結核病患醫療改善方案試辦計畫之評估 (計畫編號:DOH91-NH-1020)。  延伸查詢new window
學位論文
1.張雪芬(2003)。論質計酬試辦計畫成效初探--以肺結核疾病為例(碩士論文)。中國醫藥學院。  延伸查詢new window
圖書
1.Global tuberculosis control: surveillance, planning, financing: WHO report 2003。  new window
其他
1.行政院衛生署疾病管制局(2004)。結核病流行病學專區,http://203.65.72.83/ch/dt/upload/qc/epi/epi_face.htm。  延伸查詢new window
2.行政院衛生署疾病管制局(2004)。結核病全面品質管制報表監測,http://203.65.72.83/ch/dt/upload/QC/QC_index.htm。  延伸查詢new window
 
 
 
 
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