Knowledge-Attitude-Practice And Management Strategies Study Of Sputum Disposalforpulmonary Tuberculosis Patients

Background:Pulmonary tuberculosis is a global issue that is detrimental to the public health. There are about2million people succumbing to it every year. It is estimated that the totality will be35million. According to the assessment from the WHO, as one of the22countries mostly infected with pulmonary tuberculosis, there are about1.3million people infected by this disease in our country, which holds14%of the totality,2nd,ranking in the world. Pulmonary tuberculosis is one kind of chronic infectious diseases, which almost infecting body or organ through the respiratory; its main source of infection is the patients during sputum period. In general, the patients infected by pulmonary tuberculosis usually discharged sputum carrying the tuberculosis bacteria into the air. the sputum carrying bacteria floating onto the floor or other items, dried, and then is absorbed into the air way. Sputum smaller than10micrometers can float among the air, the vulnerable groups who absorb them, have infected food or use infected table ware, are all likely to cause infection of Pulmonary tuberculosis. Pulmonary tuberculosis needs long duration for remedy and recovery. For the overwhelming majority of patients, it is essential to stay at home for remedy after the acute stage. Therefore, it is how to handle the sputum that decides the safety and wealth of whose family members or close contacts. Objectives:This research adopts self-made questionnaire, to understand existing conditions and problems of handling the sputum from pulmonary tuberculosis patients in Shandong Province, integrate garbage management and supervising conditions to put forward valuable concerning innovative approaches and management policies.Data and Methods:This research was conducted in six counties of Shandong Province with layer-cluster random sampling. The details are as follows:at first, selecting one sample from three municipal level cities, Weihai, Linyi and Jinan. Rank these cities in accordance with the level of GDP per capita, and classified as three categories, good, average and bad. At last, Simple random sampling method was used to select two countries as the sample countries, coming to6cities. Questionnaire was conducted with800patients who chemotherapy at home in Shandong Province.Main Results:Pulmonary tuberculosis patients spit4.56times daily on average during chemotherapy at home.25.6percent of patients spit a lot, degree of education and drinking differences have statistical significance.25.3Percent of pulmonary tuberculosis patients think sputum of no infectivity. Family income, whether informed of the relevant knowledge of pulmonary tuberculosis, the necessities of supervising and managing to pulmonary tuberculosis patients have statistical significance.40.1percent of patients hold negative attitude toward the sputum disposal. Self-estimation of illness, whether told of concerning knowledge, and whether agreeing or disagreeing to supervise and manage the sputum disposal are statistic valued. There are17.9percent of patients tend to spit casually during chemotherapy at home, which Adoption rate is highest in the all sputum disposition. Region, culture degree, smoking status, whether contacted with pulmonary tuberculosis patients, whether told of concerning knowledge, and whether agreeing or disagreeing to supervise and manage the sputum disposal, differences were statistically significant. The number of patients who take protective measures when go out to avoid their sputum to cause the spread of tuberculosis is302(41.9%). Region, gender, age, occupation, smoking status, whether told of concerning knowledge and whether agreeing or disagreeing to supervise and manage the sputum disposal are statistic valued. According to the results of the structural equation model, the cognition of sputum disposal has a significant direct affection on their disposal habits of pulmonary tuberculosis patients chemotherapy at home(r=-0.472); Disposal habits for sputum have a significant direct affection on protective measures pulmonary tuberculosis patients take(r=-0.495); The cognition of sputum disposal has a significant direct affection on protective measures pulmonary tuberculosis patients take through disposal habits(r=-0.472x-0.495=0.234). The model fit the data well(x2/df=4.775, GFI=0.948, AGFI=0.918, RMSEA=0.072, RMR=0.012, NFI=0.884, CFI=0.905, IFI=0.906).Conclusion and Suggestions:Conclusion:1) More than three quarters of patients spit more than6times every day, their illness is still on the accurate stage. It is in such loose condition that vulnerable groups are more likely to be infected. So there is quite large pressure for pulmonary tuberculosis patients taking home chemotherapy in the disposal of sputum.2)More than one quarter of patients maintaining that sputum from pulmonary tuberculosis patients have no infectivity, it is evident that patients of pulmonary tuberculosis taking home chemotherapy is less cognitive of its infection.3) The patients who take an optimistic attitude towards sputum disposal take a proportion less than60%, which reveals that patients have relatively negative attitude towards sputum disposal, and further verifies that the propagation and management of sputum disposal need further improvement.4) It is researched that there is17.9%of patients spitting everywhere and the adoption rate is the highest among several disposal methods. This reveals that the sputum disposal behavior of pulmonary tuberculosis patients tends to be irrational.5) The number of patients who take protective measures when go out to avoid their sputum to cause the spread of tuberculosis is302(41.9%), suggesting that the proportion of patients who adopt measures to avoid their sputum to cause the spread of tuberculosis is very low, the opportunity is very big for patients’sputum to be exposed to the external environment which will increase the chance of infection.6) It is allowed to exert influence upon the sputum disposal behavior through enhancing the cognition of sputum disposal. Then we can make patients tend to take reasonable and right sputum disposal method, and develop good habits of sputum disposal.Suggestions:1) To actively carry out publicity and supervision work towards pulmonary tuberculosis patients to enhance their and their family’s cognition of sputum disposal.2) To carry out health education, and to focus on key crowd on the basis of guaranteeing coverage.3) To develop germ-carrying sterilization package with efficient sterilization and water-proof packing, and to give assistance to patients’safeguard during outgoing.