| Reasons for Defaulting Domiciliary TB Treatment -A Study done on Patients of a General Hospital Serving the Rural District around Wonju, Korea |
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Everett Landen1, George Cauthen1, Sang Baik Oh2 |
1U. S. Peace Corps in Korea
2Wonju Union Christian Hospital, Wonju, Korea |
| 치료 중단이유에 대한 고찰 -원주기독병원 결핵과환자에 있어서- |
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오상백1, 2 |
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| Abstract |
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A clinical and sociomedical study was made of 112 domiciliary TB patients who had defaulted treatment and of 88 who were continuing treatment (control group) at the Chest Clinic of the Wonju Christian Hospital which serves the rural district around Wonju City. From the data which was gathered in 1968, the study concludes the following about defaulting.
1) ⓐ By initial diagnosis of extent of disease, far advanced pulmonary TB was predominent in the defaulter group. Moderately advanced and far advanced TB were predominant in the control group.
Children with pulmonary and extra-pulmonary TB were relatively many in the control group.
ⓑ By positive rate of TB bacilli in sputum, no marked difference between defaulters and controls seen.
ⓒ 69% of the defaulter group had a duration of illness less than 24 months (29. 5% under 12 months and 39.3% between 12 and 24 months), but 41 % of the controls was in this category (14. 7 and 26.1% respectively). 13.4% of defaulters were rather chronic cases (duration of illness more than 48 months) compared to 32. 9% of the controls.
ⓓ Most defaulters (51. 6%) had collected drugs for a duration of less than 6 months when they discontinued treatment at the Chest Clinic. However, predominantly more of the controls (40. 9%) fell into the 7~12 months category at the time of the study.
ⓔ By drug regimen, two and three drug combinations predominated in the defaulters(49 and 49. 1 %),
whereas 64. 7% among controls were receiving a two drug combination.
ⓕ In clinical change no remarkable difference was seen between defaulters and controls.
ⓖ Out of seven occupational groups, the farmer-laborer category in the defaulter group and the unemployed in the control group were of the largest number at about a one third proportion each.
Merchants, infants and children were relatively more among the controls.
ⓗ For three categories of the distance of residence from the Chest Clinic, numbers of defaulters divided into 13. 54 and 45 from near to far. Controls divided into 37, 20 and 13.
2) On the eleven items questionaire sent out to determine reasons for defaulting, answers were as follows:
ⓐ Moved resident-7. 0%.
ⓑ Registered at goverment health center-29. 9%.
ⓒ Treatment at other hospital-4.4%.
ⓓ Drugs bought at pharmacy-19.2% . Here, ⓑ,ⓒ, and ⓓ are continuing treatment at another souce-53. 5% in all.
ⓔ No symptoms-2. 5%.
ⓕ Cured at another hospital-0. 6%.
ⓖ Doesn’t like medicine-3. 2%. Here, ⓔ, ⓕ, and ⓖ are thought to be fundamentally by carelessness and indifference-6.3% in all.
ⓗ Thinks no hope-2. 5%.
ⓘ Too far to hospital-10. 8%.
ⓙ Inconvenient to come to hospital-6.4%.
ⓚ No money-13. 4% . Here, ⓗ, ⓘ, ⓙ, and ⓚ are fundamentally by economic difficulty-33. 1 % in all.
3) Taken as factors, duration of iIIness, duration of drug collection, occupation, and distance of residence appeared to have correlation with the reasons for defaulting, while initial diagnosis of disease or clinical changes did not. |
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