Self-Management of Patients with Pulmonary Tuberculosis In Chest Dispensaries

Abstract

Tuberculosis is increasing alarmingly in the world. About 21.5 million new cases were notified by DOT program between 1993-2004. Annual risk of tuberculosis is estimated to be 2%. Probable reason for this increase in the incidence of tuberculosis in developing countries could be due to: (a) HIV epidemic, (b) Population explosion ,(c) Health care facility not accessible, (d) Poverty and civil unrest, (e) Along with drug resistance, ineffective control (Prabhakara, 2009). Each person with active TB disease will infect an average between 10 and 15 people every year. But people infected with TB bacilli will not necessarily become sick with the disease. The immune system "wall off" the TB bacilli which, protected by a thick waxy coat, can lie dormant for years. When some one's immune system is weakened, the chances of becoming sick are greater (WHO, 2010). Partially as a result of lax control measures, multi drug-resistant TB (MDR-TB) strains developed as TB clients become less compliant with their drug therapy. These strains are a public health concern because they require longer, more costly treatment. MDR-TB is often  Summary 102 fatal, the cure rate is lower approximately 50 – 60%, even with intensive treatment and follow up, so XDR-TB and MDR-TB are a serious problem world wide (Coberly & Chaisson, 2007; CDC, 2010; Maurer & Simth, 2013). Egypt is ranked among the mid-level incidence countries. TB in Egypt is considered an important public health problem. Annual risk of infection (ARI) represents the percentage of population that will be infected by tubercle bacilli every year, in 2014, ARI was calculated mathematically with help of WHO and was found to equal 24/100.000. so a total of 18,000 new sputum smear-positive TB cases were notified (www.ntp. mohealth. gov.eg/ NTP_introd.htm(2014)) Self –management is defined as the positive efforts of patients to oversee and participate in their health care in order to optimize health. Prevent complication, control symptoms and minimize the occurrence of disease into preferred lifestyles (Curtin and Mapes, 2001; Belal, 2004). The aim of this study is to assess self-management of patient with pulmonary tuberculosis in chest dispensaries through. Assessing knowledge of patients with pulmonary tuberculosis. Assessing self-care practices of patients with pulmonary tuberculosis.Determing factors that affect selfmanagement of patients with pulmonary tuberculosis.  Summary 103 Study questions: Is there relationship between knowledge of pulmonary tuberculosis patients and their self-management?Is there relationship between knowledge of pulmonary tuberculosis patients and their self-care practices?Are there factors affect on self management? Study Setting this study was conducted at 10 chest dispensaries in Cairo which are, Shobra, Abassia, Bab Sheria, Ezawia, Mataria, Khalifa, Saida Zeinab, Bolak, M Naser and Elsalam. Sampling: A purposive sample used in this study were all pulmonary tuberculosis patients in all ages groups, male and female, a total numbers of 141 patients according to their criteria who were attending the chest dispensaries in Cairo over a period of three months 4 day / week. Technical Design for data collection, one tool was used.This tool for pulmonary tuberculosis patients was an interviewing questionnaire, assessing the following items.  Patients' socio-demographic data which include age, gender, marital status,numbers of family, level of education, total income of family and if income is n't enough.  Summary 104  Patient medical history data, which include past disease,does they still suffer from, investigation they done, signs and symptoms they suffere from, there are any person of family suffere from TB?.  Patients "knowledge about tuberculosis which include definition, causes, signs and symptoms, diagnosis, complication, treatment, side effects of treatment and prevention.  patients 'self-management which include respiratory problems, infection control, and elementary problems.  Patients' self-care practices which include dietary system, sleep, and rest.  Factories affect self-management which include occupational data, which include job, type of job, place of job,and continuity.  Home environmental data, which include type of home, room number, ventilation, sun exposure, presence of animal and area of home.  Compliance of treatment which include,follow up,regularity of treatment, side effects faraway,and cost of treatment.