護理系學生參與結核病患短程直接觀察療法可行性之初探

An exploration of the supervision by student nurses of the use of Directly Observed Treatment, Short-Course (DOTs) for Tuberculosis Patients

本研究探討以護理系學生執行短程直接觀察治療對結核病患者之結核病知識、服藥遵從性的影響及訪視過程可能遭遇的問題，採單組後測之研究設計，以立意取樣方式，選取15位開放性肺結核患者，由學生督促個案服藥、提供結核病相關知識並進行資料收集。研究工具包括基本資料表、結核病知識量表、服藥遵從預測量表及訪視日誌，所得資料以描述性統計及無母數統計方法進行資料分析。研究結果有12位個案訪視日數 ≥ 90天，平均訪視日數為120.75天，家訪一個月時結核病患之結核病知識答對率達85.4％，服藥遵從預測性達73.7分。建議未來以家訪方式執行DOTs，需考慮學生之安全性、訪視地點的可近性及被傳染之可能性等問題，本研究結果可作為相關單位規劃短程直接觀察治療之參考。

This study aimed to explore the supervision by student nurses of directly observed treatment, short-course, (DOTs) for patients with pulmonary tuberculosis. The study used a single group with post-test design and this was created by purposive sampling. It involved 15 patients with open pulmonary tuberculosis. The data were collected by the student nurses who supervised the taking of medicine by the patients and the process also involved the provision of tuberculosis knowledge to the patients. The research instruments included demographic data, a tuberculosis knowledge scale, a compliance behavior scale and a daily DOTs record. The results indicated that 12 patients received more than 90 days of home visits. After the visits, patients with tuberculosis seemed to have a higher correct knowledge rates for tuberculosis and also showed greater medicine compliance behavior during a monthly follow up. This result of the study also revealed some of the problems encountered with the DOTs approach when implemented by student nurses.