The Research On The Development And Application Of Self-discipline Scale Of TB Patients Treated At Home

BackgroundChina is in the midst of the three health revolution of cross phase,chronic non-infectious diseases have become the main threat to human health,but the task of prevention and control of infectious diseases and parasitic diseases and endemic diseases has not yet been completed,and even have intensified trend,such as tuberculosis resurgence streak.According to the World Health Organization 2012 report,our country new tuberculosis years were the second largest in the world,is one of 22 high TB burden countries around the world,tuberculosis has become a significant social and public health problems.Related studies show that the higher self-discipline not only can help patients to manage their own illness,improve the quality of survival,also can be adjusted to its behavior and mood.In our country;the pulmonary tuberculosis patient undergone domiciliary chemotherapy is given priority to,therefore,tuberculosis patient’s life quality and treatment effect depends largely on its self-discipline.But at present,there are few researches on the self-discipline of patients with pulmonary tuberculosis at home and abroad.TB self-discipline evaluation scale has not yet formed not related follow-up study.Objectives1.To establish a set of self evaluation scale for the pulmonary tuberculosis patients undergone domiciliary chemotherapy.2.To explore the current situation of self-discipline of the pulmonary tuberculosis patients undergone domiciliary chemotherapy,and to measure and evaluate it.3.To determine the main factors influencing the level of self-discipline of the pulmonary tuberculosis patients undergone domiciliary chemotherapy.Methodology1.Based on literature review and semi-structured interviews,to determine the framework and item library discipline evaluation scale,and then do the preliminary screening items by Delphi method,and then use the critical ratio method,correlation coefficient method and factor analysis on the entry form tentative version of further screening,evaluation scale,after the reliability and validity of the test,determine the final version of the evaluation scale.2.In a multi-stage stratified cluster sampling method to select 350 pulmonary tuberculosis patients undergone domiciliary chemotherapy at six cities in Shandong Province as the research object,the use of pulmonary tuberculosis patients self evaluation scale,evaluation of population self-discipline level,and combining with the investigation questionnaire,the general situation of pulmonary tuberculosis patients quality of life questionnaire,self rating Depression Scale and the social support scale,carried on the investigation to determine the affecting factors of pulmonary tuberculosis patients with the level of self-discipline.3.The data were statistically analyzed by general descriptive analysis,t/F test,binary logistic regression,correlation analysis,factor analysis,path analysis and other methods.Main Results1.The compiled pulmonary tuberculosis patients undergone domiciliary chemotherapy self-discipline evaluation scale,including access to information,compliance,isolation control,daily life management and self-discipline effectiveness of five dimensions,a total of 30 entries.2.Reliability test results(1)Cronbach coefficient:the Cronbach coefficient t of each dimension of the scale is between 0.701-0.803,the total amount is 0.874.(2)Split-half reliability:the scale of the sub-half reliability of each dimension of the scale is between 0.803-0.848,the total amount of split-half reliability is 0.913.(3)The retest reliability:the scale of the retest reliability of each dimension is between 0.728-0.913,the total amount of retest reliability is 0.929.(4)The correlation coefficient between the total score of the scale and the five factors is in the0.659-0.823,were statistically.significant(P<0.01).3.Validity test resultsConstruct validity:using exploratory factor analysis,five common factors were extracted to explain 44.539%of the total variance.Criterion validity:the correlation coefficient between the total score of the chronic disease self management behavior scale and the self rating scale of self evaluation scale was between 0.489-0.589,and the correlation coefficient was 0.641.The correlation coefficient between the total score and self efficacy scale of chronic disease self efficacy scale was0.257-0.701,and the correlation coefficient was 0.568.4.The validity of the pulmonary tuberculosis patients undergone domiciliary chemotherapy self-discipline was in the middle level,and the related factors were:junior high school culture and internet access,the OR values were 0.320 and 1.702 respectively.5.The self-discipline behavior of the pulmonary tuberculosis patients undergone domiciliary chemotherapy was in the middle level,and the related factors were:35-49 years old,health education and supervision,the OR values of the three were 2.192,1.769 and 2.678 respectively.6.The overall self-discipline of.the pulmonary tuberculosis patients undergone domiciliary chemotherapy was in the middle level,and the related factors were as follows:junior middle school and below,35-49 years old,health education supervision and internet access,the OR values were 0.365,2.797,2.075,2.801 and 1.770 respectively.7.Path analysis results showed that the quality of life has a direct impact on patient self-discipline;depression not only has a direct effect on self-discipline,can also have an indirect effect on the quality of life;social support through three ways affect self-discipline:quality of life has a direct effect on self-discipline,but also through life quality and depression have indirect effect on self-discipline.Conclusion1.The self-discipline scale of the pulmonary tuberculosis patients undergone domiciliary chemotherapy has high reliability and validity,the indicators are in line with the requirements of surveying.2.The factors related to the self-discipline of the pulmonary tuberculosis patients undergone domiciliary chemotherapy were culture level,age,health education,supervision,internet access,depression,quality of life and social support.These factors directly or indirectly affect the self-discipline.Suggestions and Countermeasures1.Strengthen the knowledge of tuberculosis related knowledge;2.Strengthen the supervision and management of the pulmonary tuberculosis patients undergone domiciliary chemotherapy;3.The content of the self-discipline of the pulmonary tuberculosis patients undergone domiciliary chemotherapy is included in the relevant laws and regulations;4.Strengthen psychological counseling for the pulmonary tuberculosis patients undergone domiciliary chemotherapy;5.Strengthen the social support of pulmonary tuberculosis patients undergone domiciliary chemotherapy.