SYMPTOMS OF NEWLY DIAGNOSED PULMONARY TUBERCULOSIS AND PATIENTS ATTITUDES TO THE DISEASE AND TO ITS TREATMENT IN HONG-KONG
SYMPTOMS OF NEWLY DIAGNOSED PULMONARY TUBERCULOSIS AND PATIENTS ATTITUDES TO THE DISEASE AND TO ITS TREATMENT IN HONG-KONG
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DOI：
10.1016/0041-3879(79)90002-3
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发表时间：
1979-01-01
期刊：
影响因子：
--
通讯作者：
FOX, W
中科院分区：
文献类型：
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作者：
ALLAN, WGL;GIRLING, DJ;FOX, W
香港的政府健康访视员向201名连续痰检阳性肺结核患者和199名痰检阴性肺结核患者进行了问卷调查，这些患者因当前疾病首次前往7家全日制政府胸肺诊所中的一家。获得了有关疾病症状、政府服务以外的诊断和管理以及病人对政府服务的了解和态度的信息。在因呼吸道症状寻求治疗的343名患者中，绝大多数（81%）的第一症状是咳嗽，15%也有痰，27%咯血。仅15%的患者因咳嗽寻求治疗，而40%的患者因咯血寻求治疗。大多数患者（76%）在1个月内参加了第一次治疗或研究。但有些病人的出现时间较长;只有35%的病人在1个月内到政府胸肺科诊所求诊。（无论这是否是第一个治疗来源）。53%的患者的第一个就诊来源是私人医生，4%是另一个私人医疗机构，11%是政府胸肺诊所，17%是另一个政府医疗机构; 9%的患者首先去看中医，5%去药店或自己治疗。病人第一次到医院求诊与第一次到政府诊所求诊之间的延误是一个重要的问题，因为在政府胸肺科诊所以外，只有49%的病人接受了胸肺X光检查，只有7%的病人接受了痰细菌检查。只有33%的人甚至被怀疑患有肺结核，许多人相应地得不到充分的治疗。病人普遍对政府胸肺科诊所的服务知之甚少; 52%的病人在患病前不知道有这项服务，只有9%的病人知道这项服务是免费的，而只有12%的病人知道这项服务专门治疗结核病。需要教育公众了解结核病的症状，以及在政府胸肺科诊所接受免费检查和治疗的可能性。
A questionnaire was applied by Government Health Visitors in Hong Kong to 201 consecutive patients with smear-positive and 199 with smear-negative pulmonary tuberculosis who attended 1 of the 7 full-time Government chest clinics for the 1st time due to their current illness. Information was obtained about the symptoms of the disease and its diagnosis and management outside the Government service and about patients'' knowledge of and attitudes towards the Government service. Among the 343 patients who sought treatment because of respiratory symptoms, the 1st symptom for the great majority (81%) was cough, 15% also having sputum and 27% hemoptysis. Treatment was sought by only 15% because of cough alone compared with 40% because of hemoptysis. Most patients (76%) attended their 1st source of treatment or investigation within 1 mo. of the onset of symptoms but some allowed long delays; only 35% attended a Government chest clinic within 1 mo. (whether this was the 1st source of treatment or not). The 1st source attended was a private practitioner for 53% of the patients, another private medical establishment for 4%, a Government chest clinic for 11% and another Government medical establishment for 17%; 9% went first to a herbalist and 5% went to a drug store or treated themselves. The delays between the patients'' 1st attendance at a source of treatment and their 1st attendance at a Government clinic were important because outside the Government chest clinics only 49% were investigated by chest radiograph and only 7% by sputum bacteriology. Only 33% were even suspected of having pulmonary tuberculosis and many were correspondingly inadequately treated. The patients were generally ill informed about the Government chest clinic service; 52% did not know before their current illness of the existence of the service, only 9% knew that it was free and only 12% that it specialized in the management of tuberculosis. The public needs to be educated about the symptoms of tuberculosis and about the possibility of their being investigated and treated, free, in a Government chest clinic.