Development of Pulmonary Tuberculosis Screening Model, Out Patient Department, Phonphisai Hospital

Abstract

The Participatory Action Research which, focused on the development of a screening model for Pulmonary tuberculosis patients was designed to support the reduction. The purposive sampling which was divided into two groups: 44 health personnel involved in screening services for Pulmonary         tuberculosis and 43 patients with suspected pulmonary tuberculosis who visited the services unit during the experiment. Research conducted on 2019, December 1^st to 2020, October 31^th. This research was divided into four steps as follows: planning, implementing, evaluating and reflecting. The tools were the semi-structured in-depth interview, the assessment of knowledge and understanding of screening       pulmonary tuberculosis patients with multiple choice questions, and the satisfaction assessment of screening with rating scales. Reliability was analysed by Cronbach’s alpha at 0.92 The data were       analyzed by frequency, percentage, mean,  Paired T- test and content analysis.

The research showed that medical personnel involving in pulmonary tuberculosis screening     services lacked knowledge of the screening operation which caused imperfect screening of Pulmonary    tuberculosis suspected patients.  Some positive sputum patients were found among other patients which made high risk of spreading infection. In the procedure of the implementation, the guidelines of       Pulmonary Tuberculosis Screening were designed as follow :1) nurses with responsibility in pulmonary tuberculosis were at the OPD 2) the new screening forms were prepared at the screening area  3) counselling by the physician immediately 4) staff were given information to participate in screening  5) setting up fast-track to investigate film chest 6) the patients were appointed to have sputum smear test 7) patients were referred to specialist physicians. The evaluation of the screening model showed that screening pulmonary tuberculosis patients were 90.91 per cent accuracy. The average score of   participants' knowledge before developing guideline was lower than after attending the training program (12.57 to 15.64), this increased statistically significant (p<0.001). All participants were satisfied with screening procedure at mean score 4.2 (SD 0.51) and the most satisfying point was the advantage of screening to all participants and patients at mean score 4.7 (SD 0.46).