Adherence is associated with the quality of professional-patient interaction in Directly Observed Treatment Short-course, DOTS
Adherence is associated with the quality of professional-patient interaction in Directly Observed Treatment Short-course, DOTS
复制标题
DOI：
10.1016/j.pec.2005.08.006
复制
发表时间：
2006-10-01
影响因子：
3.5
通讯作者：
Kafle, Kumud Kumar
中科院分区：
文献类型：
--
作者：
Mishra, Pranaya;Hansen, Ebba Holme;Kafle, Kumud Kumar
目的：为了调查的卫生专业人员的行为之间的关联报告的患者，沟通的质量，患者的沟通，他们的疾病，并不坚持直接观察结核病治疗短期疗程，DOTS.Methods：本研究的目的是作为一个病例对照研究的基础上，50例（非信徒）和100个控制（信徒），在尼泊尔的一个丘陵西区进行。50例病例的参与率为80%，100例对照的参与率为95%。所有p值< 0.2的协变量均纳入多变量logistic回归模型，以确定与治疗不依从性显著相关的因素。（OR = 11.2; CI = 2.5-50.4）和良好沟通（OR = 2.7; CI = 1.2-6.3）与不依从性显著相关。卫生专业人员，特别是配药员与患者之间更好的沟通对于提高结核病治疗的依从性至关重要，即使在DOTS下也是如此。实践影响：应该对配药员进行培训，以培养他们关于药物使用、相关副作用、益处和不依从风险的沟通技巧，并尊重个体患者的自主权和完整性。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To investigate the association between the behaviour of health professionals as reported by patients, the quality of communication, patients' communication about their disease, and non-adherence to Directly Observed Tuberculosis Treatment Short-course, DOTS.Methods: This study was designed as a case-control study based on 50 cases (non-adherents) and 100 controls (adherents), conducted in a hilly western district in Nepal. The participation rate was 80% for 50 cases and 95% for 100 controls. All covariates with p-value < 0.2 were included in a multivariate logistic regression model to identify the factors significantly associated with treatment non-adherence.Results: The analysis identified that poor-grade communication (OR = 11.2; CI = 2.5-50.4) and fair-grade communication (OR = 2.7; CI = 1.2-6.3) between patients and dispensers were significantly associated with non-adherence.Conclusion: Better communication between health professionals, particularly dispensers, and patients is essential for improving treatment adherence in TB treatment, even under DOTS.Practice implications: Drug dispensers should be trained to develop their communication skills about the use of medications, associated side effects, benefits and risk of non-adherence, as well as to respect the individual patient's autonomy and integrity. (c) 2005 Elsevier Ireland Ltd. All rights reserved.