Social support from nurses and non‐adherence with directly observed therapy (DOTS) maintenance phase among patients with tuberculosis in Metro Manila, Philippines

Abstract

Objective:To determine the influence of community health nurses' social support on non-adherence with the maintenance phase of directly observed therapy (DOTS) among patients with tuberculosis (TB).Design: Prospective-cohort. Sample:One hundred purposively selected patients with TB starting with DOTS maintenance phase. Measurements:Participants answered the robotfoto and Berlin Social Support Scale (BSSS) to assess demographics and social support provided by nurses. Non-adherence was measured using the attendance record and documented in an abstraction form.Cox proportion-hazards regression determined the influence of social support provided by nurses to non-adherence. Results:With a median adherence of 3 weeks, 15% of the sample was non-adherent. The hazard of non-adherence was lower with high perceived emotional support (HR = 0.25, p = .046), perceived instrumental support (HR = 0.20, p = .044), perceived support seeking (HR = 0.27, p = .045), and received emotional support (HR = 0.45, p = .045).High received emotional support increased non-adherence (HR = 2.65, p = .039). Conclusion: Social support from nurses influenced DOTS non-adherence among patients with TB, a critical issue in the development of drug-resistance. Perceived emotional, instrumental, support seeking and received emotional support decreased the hazard of non-adherence, while received emotional support increased non-adherence. This study highlights the need to promote positive perception of instrumental support needs. Appropriate interventions should be provided to promote supportseeking skills. K E Y W O R D S community health nurses, DOTS program, perceived social support, Philippines, received social support 2 | ME THODS | Research design, subjects, and settingThis study employed a prospective-cohort design and recruited participants who were at least 18 years old, category I (newly diagnosed, smear-positive) pulmonary TB patients, about to start the maintenance phase of the DOTS program.A total of 100 purposively selected participants were included which yielded a power of 99.97% at a significance of 5% (two-tailed).This study was conducted in selected health centers from the cities of Manila, Quezon, and Marikina, Philippines. These health centers are accredited DOTS Satellite Treatment Centers of the Philippine Department of Health and provide a variety services for patients with TB. | Data measuresParticipants completed a two-part survey composed of the robotfoto and the BSSS. The robotfoto, a Dutch term denoting one's

The Role of Nurses in Providing Social Support in Tuberculosis Treatment: Literature Review

“…including expressions of empathy, care, and attention given by the nurse as treatment supervisor for tuberculosis patients . In addition, according to research conducted in the Philippines social support and positive emotional perceptions, given by nurses to patients who are undergoing TB treatment can affect patient compliance in undergoing tuberculosis treatment (Baniqued et al, 2020). in addition nurse plays a role in giving Educating patients, administering medication, communicating with patients, observing and following up on treatment (Carlsson et al, 2019).…”

“…This is due to the non-stop treatment which lasts 6 to 8 months (Christof et al, 2020). The continuous treatment process will have a psychological impact on Tuberculosis patients such as feeling boredom and tired in undergoing the treatment process (Baniqued et al, 2020;Nezenega et al, 2020).…”

“…Social support from health workers and nursing is needed by TB patients because this social support can create a feeling of security, attention, comfort because they feel that there are other individuals who support, accept their existence, and do not isolate them. In addition, the positive perceptions that arise from this social support can also help eliminate negative attitudes of Tuberculosis patients such as eliminating feelings of inferiority (Baniqued et al, 2020;Nezenega et al, 2020;Watermeyer and Penn, 2019).…”

The Correlation of Family Support and Health Worker Support With Medication Adherence of Tb Patients at Puskesmas (Public Health Service) Taman

“…Good communication between patients and health workers is an important factor in patient compliance (Sukartini, T., Sitorus, R., Waluyo, A., & Darmawan, 2015). Therefore, having a professional health worker who shows genuine compassion and concern for the health, emotional, and social suffering experienced by TB patients assures them to continue medication adherence (Baniqued et al, 2020).…”

“…The support of health workers is professional social support such as doctors, nurses and other professionals (Gottlieb & Bergen, 2010). As one of the main elements of DOTS, health care providers must participate actively in patient care (Baniqued et al, 2020). Social support has a support component such as emotional support, informational support, reward support and instrumental support (Sarafino & Smith, 2011).…”