Factors Associated with Self-care Behaviors among New Pulmonary Tuberculosis Cases in Thasala Hospital, Nakhon Si Thammarat Province

Abstract

The purposes of this analytical cross-sectional study were to study the situation and determine factors related to self-care behavior among pulmonary tuberculosis (TB) patients at the Thasala Hospital, Nakhon Si Thammarat province. Data from 141 new patients at a tuberculosis clinic during January – December 2019 were collected using a questionnaire and the medical records of tuberculosis treatment history. The study results showed that 91% of patients were new pulmonary tuberculosis cases were found, 6.3% were recurrent cases, 1.4% returned to receive treatment, and 0.9 % were new cases with discontinuation of treatment. The majority of the participants (75.2 %) were male. The average age was 49.28 years. Most of the participants (76.8%) were married. Most Many of the patients were self-employed (39.7%). M, most of them obtained a primary-level education (63.7%). Their average income was 9,457.4 baht/month. , 52.9% were smokers., and 31.4% drank alcoholic beverages., 30.6% had a history of chronic diseases including asthma, pneumonia, and emphysema,. 28.9% had initial symptoms and were exposed to tuberculosis patients. In terms of symptoms, 84.3% were chronic cough, 37.5% were fever, 13.8% were fatigue. 76.9% were had weight loss and night sweats, 50.7% were received treatment and guidance for self-care in at government hospitals. Most of the participants (64.5%) were received information regarding the disease and self-care from newspapers, television, and health volunteers. 50.7% traveled to the health center by motorbike., 77.6% traveled alone. The average distance from home to health center was 11.06 kilometers. The average cost of each trip to the hospital was 194.86 baht. Main expenses related to tuberculosis included were food, travel expenses, medicines and medical care. The reason for not receiving treatment was having an asymptomatic tuberculosis infection. Some patients did not know that they had tuberculosis, (71.4 %), and instead they thought that just a pulmonary disease (64.3%). Most Almost half of them had basic knowledge regarding TB at a high level (47.9%) and they had good self-care behaviors (45.5%). Factors related to self-care behavior among pulmonary tuberculosis patients in Thasala Hospital, Nakhon Si Thammarat province that were statistically significant (P<0.05) includeding: age, distance, expenditure, and being a care giver  (P=0.037, 0.048, 0.005, and 0.021, respectively). Future study of tuberculosis patients should include, quality of life, TB active case finding, and development of patient services system, as well as surveillance of new pulmonary TB patients.