Factors Affecting Self-management in Iranian Tuberculosis Patients: A Path Analysis Model

Abstract

Background Tuberculosis is a chronic infectious disease that, if not treated and managed properly, increases the Multi Drug Resistance (MDR). Self-management behaviors can reduce the progression of illness. Although various factors affect self-management, no study has not been conducted on the self-management tuberculosis through path analysis. This study evaluated the factors affecting self-management in tuberculosis patients using path analysis. Methods This study was a cross-sectional study and was done on 133 non prisoner tuberculosis (TB) patients that referred to all health centers in Karaj, Iran from March 2016 to February 2017.The structured questionnaire was applied. Data were analyzed with SPSS-17 and Lisrel 8.8, utilizing statistical path analysis to evaluate the relationships between self-management and its related factors. Results 52.3% of the participants in the study were female and 47.7% were male. Respondents of this research were 46.9% smear-positive, 9.4% smear- negative, 43.8% extra-pulmonary TB. Fit indices confirmed the model fitness and logical relationships between the variables according to the conceptual model (X2=49.80, df=25). The final path model showed that the age (B=0.84), attitude (B=0.10), marital status (B=0.04) and house condition (B=0.03) impact self-management just through direct path. Knowledge (B=0.83) and education (0.16) affect the self-management through both direct and indirect paths. The education indirectly affects the self-management through both knowledge and attitude. knowledge indirectly impact self-management through attitude. In other words knowledge and attitude mediate the relationship between some factors and self-management. Conclusions This study provided an empirical model that illustrates the relationships between self-management and related factors in TB Patients. The most important factor that affects self-management through both direct and indirect paths was knowledge. The knowledge can be the target of interventions in support of self-management

Factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty: a systematic review

“…However, when evaluated separately, treatment default was higher in people under 43 years old (27) , while death was higher in people aged ≥30 years old (27) . Thus, it seems that TB treatment default in the prison unit is more common among young people, consistent with a study showing that older individuals with the disease were more concerned with self-care and cared more for their health (29) . Despite this, everything indicates that older people are more likely to die, and this is due to the overlapping of comorbidities in this population and greater toxicity of antituberculous drugs in these individuals (30) .…”

“…Regarding education, a survey showed that individuals with more than eight years of education were less likely to discontinue treatment and die from other causes (27) . Another study shows that the lower level of knowledge about TB was associated with people with low level of education (33) , who are less concerned with self-care (29) and, therefore, discontinue treatment and are subject to a higher risk of death. Thus, it is worth emphasizing the importance of health education actions aimed at these individuals, with a view to increasing the level of knowledge about the disease and its treatment, as well as the need to maintain such treatment even after symptoms improve (34) .…”