[학위논문]다제내성결핵환자의 가족지지, 가족외지지, 낙인이 치료이행에 미치는 영향 The Effects of Family Support, Non-Family Support and Stigma on Treatment Adherence in Patients with Multidrug-Resistant Tuberculosis.원문보기
본 연구는 다제내성결핵환자의 가족지지, 가족외지지, 낙인, 치료이행의 상관관계를 파악하고 치료이행에 영향을 미치는 요인을 파악하기 위한 서술적 조사 연구이다. 연구대상자는 경남 소재 C시 국립결핵병원의 외래를 방문한 다제내성결핵환자 90명을 대상으로 자가보고형의 설문지를 이용하여 자료수집 하였다. 수집된 자료는 SPSSWIN 23.0 프로그램을 이용하여 기술통계, ...
본 연구는 다제내성결핵환자의 가족지지, 가족외지지, 낙인, 치료이행의 상관관계를 파악하고 치료이행에 영향을 미치는 요인을 파악하기 위한 서술적 조사 연구이다. 연구대상자는 경남 소재 C시 국립결핵병원의 외래를 방문한 다제내성결핵환자 90명을 대상으로 자가보고형의 설문지를 이용하여 자료수집 하였다. 수집된 자료는 SPSSWIN 23.0 프로그램을 이용하여 기술통계, t-test, ANOVA, Pearson's correlation coefficients, Multiple regression analysis으로 분석하였다.
주요 연구결과는 다음과 같다.
1) 대상자가 지각하는 가족지지는 5점 만점에 3.96±0.74점으로 나타났으며, 가족외지지는 5점 만점에 3.76±0.64이며, 낙인의 점수는 5점 만점에 3.28±0.74점으로 나타났고, 이 중 결핵에 대한 타인의 관점은 3.44±0.76점, 자신의 관점은 3.09±0.85점이며, 치료이행의 점수는 5점 만점에 4.08±0.52점으로 나타났다. 2) 대상자의 특성에 따른 가족지지는 주관적 경제상태(t=2.06, p=.042), 동거가족 여부(t=-4.29, p=.001), 주관적 건강상태(F=3.15, p=.048)가 통계적으로 유의한 차이가 나타났다. 3) 대상자의 특성에 따른 가족외지지는 직업 유무(t=-2.32, p=.023)와 주관적 경제상태(t=2.18, p=.032), 약물부작용 경험(t=-2.48, p=.044)이 통계적으로 유의한 차이가 나타났다. 4) 대상자의 특성에 따른 낙인은 주관적 경제상태(t=-2.46, p=.016)와 음주여부(t=2.13, p=.036)에서 통계적으로 유의한 차이가 나타났다. 5) 대상자의 특성에 따른 치료이행은 주관적 영양상태(F=3.12, p=.049)에서 통계적으로 유의한 차이가 나타났다. 6) 대상자의 치료이행은 가족지지(r=0.246, p=.019), 가족외지지(r=0.360, p<.001)와 통계적 유의한 정적상관이 있었으나 낙인(r=0.160, p=.133)과는 통계적 유의한 상관관계가 없었다. 가족외지지와 낙인 간에는 통계적 유의한 부적상관이 있었다(r=-0.231, p=.029) 7) 대상자의 치료이행에 영향을 주는 요인은 가족외지지(B=0.34, p=.001)와 주관적 영양상태가 양호함(B=0.31, p=.007), 낙인(B=0.17, p=.015)으로 나타났다. 회귀모형의 설명력은 20.0%로 유의하였다(F=6.40, p=<.001).
이상의 결과를 통해 다제내성결핵환자의 치료이행은 가족외지지와 주관적 영양상태, 낙인에 영향을 받는 것을 확인하였으므로 다제내성결핵환자의 치료이행을 촉진하기 위해 가족외지지를 향상시키기 위한 노력과 주기적으로 영양 상담과 교육이 수반 되어야 할 것이며, 결핵 환자가 느끼는 낙인이 줄어들 수 있도록 지속적인 교육과 상담 등의 지역사회의 관리가 필요할 것으로 생각된다.
본 연구는 다제내성결핵환자의 가족지지, 가족외지지, 낙인, 치료이행의 상관관계를 파악하고 치료이행에 영향을 미치는 요인을 파악하기 위한 서술적 조사 연구이다. 연구대상자는 경남 소재 C시 국립결핵병원의 외래를 방문한 다제내성결핵환자 90명을 대상으로 자가보고형의 설문지를 이용하여 자료수집 하였다. 수집된 자료는 SPSS WIN 23.0 프로그램을 이용하여 기술통계, t-test, ANOVA, Pearson's correlation coefficients, Multiple regression analysis으로 분석하였다.
주요 연구결과는 다음과 같다.
1) 대상자가 지각하는 가족지지는 5점 만점에 3.96±0.74점으로 나타났으며, 가족외지지는 5점 만점에 3.76±0.64이며, 낙인의 점수는 5점 만점에 3.28±0.74점으로 나타났고, 이 중 결핵에 대한 타인의 관점은 3.44±0.76점, 자신의 관점은 3.09±0.85점이며, 치료이행의 점수는 5점 만점에 4.08±0.52점으로 나타났다. 2) 대상자의 특성에 따른 가족지지는 주관적 경제상태(t=2.06, p=.042), 동거가족 여부(t=-4.29, p=.001), 주관적 건강상태(F=3.15, p=.048)가 통계적으로 유의한 차이가 나타났다. 3) 대상자의 특성에 따른 가족외지지는 직업 유무(t=-2.32, p=.023)와 주관적 경제상태(t=2.18, p=.032), 약물부작용 경험(t=-2.48, p=.044)이 통계적으로 유의한 차이가 나타났다. 4) 대상자의 특성에 따른 낙인은 주관적 경제상태(t=-2.46, p=.016)와 음주여부(t=2.13, p=.036)에서 통계적으로 유의한 차이가 나타났다. 5) 대상자의 특성에 따른 치료이행은 주관적 영양상태(F=3.12, p=.049)에서 통계적으로 유의한 차이가 나타났다. 6) 대상자의 치료이행은 가족지지(r=0.246, p=.019), 가족외지지(r=0.360, p<.001)와 통계적 유의한 정적상관이 있었으나 낙인(r=0.160, p=.133)과는 통계적 유의한 상관관계가 없었다. 가족외지지와 낙인 간에는 통계적 유의한 부적상관이 있었다(r=-0.231, p=.029) 7) 대상자의 치료이행에 영향을 주는 요인은 가족외지지(B=0.34, p=.001)와 주관적 영양상태가 양호함(B=0.31, p=.007), 낙인(B=0.17, p=.015)으로 나타났다. 회귀모형의 설명력은 20.0%로 유의하였다(F=6.40, p=<.001).
이상의 결과를 통해 다제내성결핵환자의 치료이행은 가족외지지와 주관적 영양상태, 낙인에 영향을 받는 것을 확인하였으므로 다제내성결핵환자의 치료이행을 촉진하기 위해 가족외지지를 향상시키기 위한 노력과 주기적으로 영양 상담과 교육이 수반 되어야 할 것이며, 결핵 환자가 느끼는 낙인이 줄어들 수 있도록 지속적인 교육과 상담 등의 지역사회의 관리가 필요할 것으로 생각된다.
The purpose of this study was to investigate family and non-family support, stigma, and treatment adherence, and examine whether there is a difference of family and non-family support, stigma, and treatment adherence according to their general and treatment-related characteristics, to identify corre...
The purpose of this study was to investigate family and non-family support, stigma, and treatment adherence, and examine whether there is a difference of family and non-family support, stigma, and treatment adherence according to their general and treatment-related characteristics, to identify correlation among the research variables and also to identify factors influencing the treatment adherence of patients with multidrug-resistant tuberculosis. The study was designed as a descriptive survey design, using a self-reporting questionnaire and was conducted in a national tuberculosis hospital between August 1 and October 30, 2016. Data was collected using a convenience sample consisting of 90 outpatients. Completed data sets obtained from 90 participants were analyzed with IBM SPSS 23.0 software using descriptive statistics, t-test, ANOVA, pearson’s correlation coefficients and multiple regression analysis.
The main research results are as follows:
1) The family support perceived by the participants was 3.96±0.74 out of 5 points, non-family support was 3.76±0.64 out of 5 points. stigma score was 3.28±0.74 out of 5 points, the sub-domain of other people's viewpoint of tuberculosis was 3.44±0.76, self-view was 3.09±0.85, and the treatment adherence score was 4.08±0.52 out of 5 points.
2) Depending on the participants' general and treatment-related characteristics, statistically significant differences were found for family support in the subjective economic conditions (t=2.06, p=.042), living together with family members (t=4.29, p=.001), and subjective health conditions (F=3.15, p=.048). Non-family support was significantly different for having a job (t=-2.32, p=.023), subjective economic conditions (t=2.18, p=.032) and experiences from drug side effects (t=-2.48, p=.044). Stigma was significantly different for the subjective economic conditions (t=-2.46, p=.016) and alcohol consumption (t=2.13, p=.036). Treatment adherence was significantly different for the subjective nutritional status (F=3.12, p=.049).
3) A significant positive correlation was found between treatment adherence and family support (r=0.246, p=.019), and between treatment adherence and non-family support (r=0.360, p=<.001), On the other hand, there was a significant negative correlation between non-family support and stigma (r=-0.231, p=.029). However, there was no significant correlation between treatment adherence and stigma (r=0.160, p=.133).
4) According to the results of regression analysis, the factors influencing treatment adherence were non-family support (B=0.314, p=.001), subjective nutritional status (B=0.31, p=.007) and stigma (B=0.17, p=.015). The explanatory power of the regression model was 20.0% (F=6.40, p<.001).
In summary, the findings of this study showed that the treatment adherence of patients with multidrug-resistant tuberculosis was influenced by non-family support, subjective nutritional status, and stigma. Therefore, in order to promote treatment adherence of patients with multidrug-resistant tuberculosis, healthcare professionals should be included in the periodic nutritional counseling and educational program, as they often have a high level of interaction with patients. There is also a need to develop supportive strategies to enhance and improve the support system of healthcare providers and reduce the stigma of tuberculosis. This study has contributed to an understanding of factors that influence the treatment adherence of patients with multidrug-resistant tuberculosis. However, because this study was conducted in a single hospital, the results cannot be generalized, so future studies should consider using a multisite design to increase the generalizability of their finding.
The purpose of this study was to investigate family and non-family support, stigma, and treatment adherence, and examine whether there is a difference of family and non-family support, stigma, and treatment adherence according to their general and treatment-related characteristics, to identify correlation among the research variables and also to identify factors influencing the treatment adherence of patients with multidrug-resistant tuberculosis. The study was designed as a descriptive survey design, using a self-reporting questionnaire and was conducted in a national tuberculosis hospital between August 1 and October 30, 2016. Data was collected using a convenience sample consisting of 90 outpatients. Completed data sets obtained from 90 participants were analyzed with IBM SPSS 23.0 software using descriptive statistics, t-test, ANOVA, pearson’s correlation coefficients and multiple regression analysis.
The main research results are as follows:
1) The family support perceived by the participants was 3.96±0.74 out of 5 points, non-family support was 3.76±0.64 out of 5 points. stigma score was 3.28±0.74 out of 5 points, the sub-domain of other people's viewpoint of tuberculosis was 3.44±0.76, self-view was 3.09±0.85, and the treatment adherence score was 4.08±0.52 out of 5 points.
2) Depending on the participants' general and treatment-related characteristics, statistically significant differences were found for family support in the subjective economic conditions (t=2.06, p=.042), living together with family members (t=4.29, p=.001), and subjective health conditions (F=3.15, p=.048). Non-family support was significantly different for having a job (t=-2.32, p=.023), subjective economic conditions (t=2.18, p=.032) and experiences from drug side effects (t=-2.48, p=.044). Stigma was significantly different for the subjective economic conditions (t=-2.46, p=.016) and alcohol consumption (t=2.13, p=.036). Treatment adherence was significantly different for the subjective nutritional status (F=3.12, p=.049).
3) A significant positive correlation was found between treatment adherence and family support (r=0.246, p=.019), and between treatment adherence and non-family support (r=0.360, p=<.001), On the other hand, there was a significant negative correlation between non-family support and stigma (r=-0.231, p=.029). However, there was no significant correlation between treatment adherence and stigma (r=0.160, p=.133).
4) According to the results of regression analysis, the factors influencing treatment adherence were non-family support (B=0.314, p=.001), subjective nutritional status (B=0.31, p=.007) and stigma (B=0.17, p=.015). The explanatory power of the regression model was 20.0% (F=6.40, p<.001).
In summary, the findings of this study showed that the treatment adherence of patients with multidrug-resistant tuberculosis was influenced by non-family support, subjective nutritional status, and stigma. Therefore, in order to promote treatment adherence of patients with multidrug-resistant tuberculosis, healthcare professionals should be included in the periodic nutritional counseling and educational program, as they often have a high level of interaction with patients. There is also a need to develop supportive strategies to enhance and improve the support system of healthcare providers and reduce the stigma of tuberculosis. This study has contributed to an understanding of factors that influence the treatment adherence of patients with multidrug-resistant tuberculosis. However, because this study was conducted in a single hospital, the results cannot be generalized, so future studies should consider using a multisite design to increase the generalizability of their finding.
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