| A Socio-medical Study on Newly Registered Patients of Pulmonary Tuberculosis at Urban Health Centers |
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In Cheol Bae, Byong Won Jin |
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The Korean Instute of Tuberculosis The Korean National TB Association, Seoul, Korea |
| 보건소 신규등록 결핵환자의 사회의학적 조사 |
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배인철, 진병원 |
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| Abstract |
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A socio-medical study was conducted with 748 tuberculosis(TB) patients newly registered at 9 health centers in Seoul City for 2 months, July and August 1976. They were questioned on 3 major points to obtain basic data contributing to improving the national TB programme as follows : 1) General characteristics, 2) Knowledge related with tuberculosis, 3) Previotls chemotherapy and other subjects influenced on the treatment of tuberculosis.
When patients were newly registered at health centers, TB doctors obtained data by interviewing them with a prepared questionair paper. The results were as follows:
1) General Chracteristcs of the patients.
By sex, 65.4% were male and 34. 6 % female.
By age, 71. 5% were 20-49 years-old group, which is specially singnifcant because this age group is most active socially and in terms of labor production. 19 years or below accounted for only 13.5% and those 50 years and older were only 15.0%.
Among them, positive cases by initial sputum examination rated 39.2% and negative cases were:
60.8%.
55.9% among them had received a middle school education or more and 44.1 % had primary school background or below. A larger proportion or 64.2% of male patients had received a middle school education or more, of females, those having primary school background or below rated 59.9%.
By occupation at the time they were registered, no occupation totaled 31.3%, in male 18.0% and in female 56.4%. Merchant or salesman rated 12.3%, in male 17.2% and in female 3.1% .
Official worker rated 11. 0%, among male 13.5% and among female 6.2%. and industrial workers
were 9. 9%, among male 13. 1 % and among female 3.9%.
2) Knowledge related with tuberculosis 71. 0% of respondents answered that TB is communicable disease, but 5.2% of them thought that it is hereditary. The higher the educational level, the greater was the correct understanding about the nature of tuberculosis. About 85% of college and high school educational group knew T B is a communicable disease, but in the illiterate group, it rated only 46.2 %.
For the questi on as to whether TB is curable or not, 75.0 % of respondents agreed with answer that it could be cured . 95.7 % of college education group unders tood that it is curable, but of ilIiterate group it rated only 51. 6%.
For the question of the preventability of TB, those answering "yes" were 60.8% and others answered "no" or "don't know". College education group who answered "yes" rated 95.7% , but among illiterate group it was only 31. 2%.
Those who know BCG, the preventive vaccine of TB, rated 29. 5% and even among the college educated group, it was known only to 56. 5%. In the illiterate group, only 4.3% knew of the BCG.
3) Previous chemotherapy and other subjects influencing the treatment of tuberculosis.
45.9% of the respondents had previous chemotherapy and 79.9% of these had received treatment less than 1 year. Of those respondents having had under one year of treatment, 65.0% had less than 3 months. By place where they had been treated, 93.3 % among those receiving treatment at a pharmacy had received treatment less than 1 year and in the case of private clinics it rated 92.9%, but in the case of health centers it was only 44.6%.
Among the patient group who had received treatment less than 1 year, 81. 0% had stopped taking drugs and 49.0% were continuing when they were registered at the health center.
Regarding motivation of discontinuing treatment, economical reason showed the highest reat with 29.7 %, misunderstanding that they were cured and free from symptoms was 24.8 %. It was remarkable th at 59.2 % among those who had received treatment at private clinics had been discontinued for econmic reasons.
INH, PAS and SM for TB treatment had been taken by 94.6 % of patients received previous chemotherapy. EMB, a secondary drug for TB treatment, had been taken by 49.2% of them and in pharmacy treatment group, it rated 59.6% with the highest proportion. Besdies EMB among so called secondary drugs, 1321 rated 23. 7% in general hospital treatment group, KM 38.6% in private clinic treatment group and RMP 22.3% in pharmacy treatment group.
When they received regimen or diagnosis, 52.8% had been informed that they should take drugs continuosly at least for 1 year and over.
During treatment, those who had received any attention from physician or drug distributor rated 54.8% of the total. The highest proportion of them or 60.1% had been told that they should give up drinking and smoking. Information about regular drug taking, which is most important for TB treatment, had been given only to 36.2% of them while that about rest and nutrition rated 30% and over.
Physicians initiated discussion about economic capabilities with only 8.2% of the patients and beyond that only 25.3% of the patients asked the physician about treatment expenses. It was thought that patients were isolated from the physician. |
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