探討個別性衛教對結核病患疾病認知、態度及行為意向之成效

Tuberculosis Patient Disease Knowledge, Attitudes and Behavioral Intentions: The Impact of Individualized Counseling

背景：基於台灣隨著結核病發生率及多重抗藥性結核病的增加，目前政府以個案管理制度來提升追蹤率及監測照顧品質。個案管理制度可以提升整體性的照顧，但仍需要證實其成效。 目的：探討經由結核個案管理師的個別性衛教後，對結核病患的疾病認知、態度及行為意向之成效。 方法：採單組前後測類實驗研究設計。以3份結構性量表，包括「疾病認知」、「態度」及「行為意向」等量表進行問卷調查，依問卷結果及個別需求給予衛教指導及追蹤；再於30－42天後進行第二次的問卷調查。 結果：共收案96人。結果顯示：給予個別性衛教指導可顯著提升個案對結核病的疾病認知（p < .001）；另外研究發現態度與行為意向，達顯著正相關（p < .001）。 結論：實務應用 結核病診斷初期，即早給予個別性的衛教指導將可提升病患認知，了解治療的重要性，增加遵從性及治癒率。

Background: The Taiwan government currently promotes a case management approach to tuberculosis (TB) treatment to address the growing number of TB and multiple drug-resistant TB cases in Taiwan. The approach aims to improve medical follow-up and monitor quality of care. The efficacy of this case management approach has yet to be evaluated. Purpose: The current study was designed to evaluate the effect of individualized case manager counseling on TB patient disease knowledge, attitudes, and behavioral intention. Methods: This study employed a one-group pretest-posttest quasi-experimental design. Participants first answered an initial questionnaire survey including three structured scales that addressed, respectively, the facets of disease knowledge, attitudes, and behavioral intention. TB case managers then delivered two- stage counseling to participants based on assessed individual needs and outstanding issues identified in questionnaire answers. A second questionnaire survey was administered 30~42 days after the intervention. Results: Data on a total of 96 TB patients were collected. Key study findings were (1) individualized counseling significantly improved TB patient disease knowledge (p < .001) and (2) TB patient attitudes correlated significantly and positively with behavior intention (p < .001). Conclusions / Implications for Practice: Individualized counseling provided during the early stages of TB helps elevate patient awareness of the importance of treatment, enhances compliance and increases the cure rate.