Quality of Life among Pulmonary Tuberculosis Patients under Treatment in Eastern Taiwan

台灣東部肺結核病患治療期間生活品質的變化

10.6288/TJPH201433102089

鐘威昇(Wei-Sheng Chung)；李其融(Chi-Rong Li)；廖翎聿(Lin-Yu Liao)；楊文達(Wen-Ta Yang)

生活品質 ； 肺結核病患 ； 副作用 ； quality of life ； TB patients ； adverse reactions

台灣公共衛生雜誌

33卷1期（2014 / 02 / 01）

23 - 35

英文

Objectives: We evaluate the quality of life (QOL) among tuberculosis (TB) patients during different treatment periods. Methods: We conducted a population based cohort study in Eastern Taiwan. The short version of the World Health Organization quality of life (WHOQOL) questionnaire was administered to TB patients under treatment at 3 periods: during an initial treatment period, at a 2-month treatment period, and after a 6-month treatment period. Results: 140 TB patients were interviewed after approval by institutional review boards and interviewee informed consents. The average age of the patients was 48.9 years (SD=18.9 years) and more than half of them were men. Physical domain scores decreased significantly from the initial treatment to the 2-month anti-TB treatment (12.517±2.832, 11.667±3.179, p＜.001), and then increased after a 6-month treatment (12.691±2.903). Social domain scores also significantly decreased from the initial treatment to the 2-month anti-TB treatment (13.618±2.685, 12.899±2.953, p＜.05), and then increased after 6 months of treatment (13.900±2.552).While controlling probable factors affecting the 4 domain scores related to QOL, drugs related hepatitis reduced physical (β=2.3700, p＜.001), psychological (β=2.633, p＜.001), social (β=4.135, p＜.001), and environmental domain scores (β=3.449, p＜.001) and blurred vision significantly reduced physical (β=2.290, p＜.001), psychological (β=2.127, p＜.001), social (β=1.075, p＜.05), and environmental domain scores (β=1.587, p＜.01). Physical domain scores significantly decreased as age increased per 10-year (β=0.39, p＜.01). The patients employed exhibited significantly higher scores of physical, social, and environmental domains compared than those who were unemployed (β=0.959, p＜.05, β=0.815, p＜.05, and β=0.852, p＜.05 respectively). The patients with a higher income showed fewer scores of psychological domain (β=2.029, p＜.01) compared than those who having a lower income. Conclusions: TB affected individual health and QOL, although patients underwent effective treatment. Healthcare workers should be concerned regarding the adverse reactions of anti-TB drugs.

Objectives: We evaluate the quality of life (QOL) among tuberculosis (TB) patients during different treatment periods. Methods: We conducted a population based cohort study in Eastern Taiwan. The short version of the World Health Organization quality of life (WHOQOL) questionnaire was administered to TB patients under treatment at 3 periods: during an initial treatment period, at a 2-month treatment period, and after a 6-month treatment period. Results: 140 TB patients were interviewed after approval by institutional review boards and interviewee informed consents. The average age of the patients was 48.9 years (SD=18.9 years) and more than half of them were men. Physical domain scores decreased significantly from the initial treatment to the 2-month anti-TB treatment (12.517±2.832, 11.667±3.179, p＜.001), and then increased after a 6-month treatment (12.691±2.903). Social domain scores also significantly decreased from the initial treatment to the 2-month anti-TB treatment (13.618±2.685, 12.899±2.953, p＜.05), and then increased after 6 months of treatment (13.900±2.552).While controlling probable factors affecting the 4 domain scores related to QOL, drugs related hepatitis reduced physical (β=2.3700, p＜.001), psychological (β=2.633, p＜.001), social (β=4.135, p＜.001), and environmental domain scores (β=3.449, p＜.001) and blurred vision significantly reduced physical (β=2.290, p＜.001), psychological (β=2.127, p＜.001), social (β=1.075, p＜.05), and environmental domain scores (β=1.587, p＜.01). Physical domain scores significantly decreased as age increased per 10-year (β=0.39, p＜.01). The patients employed exhibited significantly higher scores of physical, social, and environmental domains compared than those who were unemployed (β=0.959, p＜.05, β=0.815, p＜.05, and β=0.852, p＜.05 respectively). The patients with a higher income showed fewer scores of psychological domain (β=2.029, p＜.01) compared than those who having a lower income. Conclusions: TB affected individual health and QOL, although patients underwent effective treatment. Healthcare workers should be concerned regarding the adverse reactions of anti-TB drugs.

1. Chang FY. Statistics of Communicable Diseases and Surveillance Report. Taipei, Taiwan: Centers for Disease Control, Ministry of Health and Welfare, R.O.C. (Taiwan), 2011.
2. WHO. World stop tb day fact sheet for the media. Available at: http://www.wpro.who.int/media_centre/fact_sheet/whol05. Accessed March 23, 2012.
3. Abioye, IA,Omotayo, MO,Alakija, W(2011).Sociodemographic determinants of stigma among patients with pulmonary tuberculosis in Lagos, Nigeria.Afr Health Sci,11(Suppl 1),S100-4.
4. Aggarwal, AN,Gupta, D,Janmeja, AK,Jindal, SK(2013).Assessment of health-related quality of life in patients with pulmonary tuberculosis under programme conditions.Int J Tuberc Lung Dis,17,947-53.
5. Anonymous(1998).Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group.Psychol Med,28,551-8.
6. Atif, M,Sulaiman, SA,Shafie, AA,Ali, I,Hassali, MA,Saleem, F(2012).WHO guidelines for treatment of tuberculosis: the missing links.Int J Clin Pharm,34,506-9.
7. Calman, KC(1984).Quality of life in cancer patients - an hypothesis.J Med Ethics,10,124-7.
8. Centers for Disease Control, Ministry of Health and Welfare, R.O.C.(2007).Taiwan Tuberculosis Control Report.Taipei, Taiwan:CDC Taiwan.
9. Chamla, D(2004).The assessment of patients' health-related quality of life during tuberculosis treatment in Wuhan, China.Int J Tuberc Lung Dis,8,1100-6.
10. Chang, LL(2004)。Hualien，Department of Indigenous Development, National Dong Hwa University。
11. Christodoulou, M(2011).The stigma of tuberculosis.Lancet Infect Dis,11,663-4.
12. Chung, WS,Chang, RE,Guo, HR(2007).Variations of care quality for infectious pulmonary tuberculosis in Taiwan: a population based cohort study.BMC Public Health,7,107.
13. Chung, WS,Chang, YC,Yang, MC(2007).Factors influencing the successful treatment of infectious pulmonary tuberculosis.Int J Tuberc Lung Dis,11,59-64.
14. Deribew, A,Deribe, K,Reda, AA(2013).Change in quality of life: a follow up study among patients with HIV infection with and without TB in Ethiopia.BMC Public Health,13,408.
15. Dion, MJ,Tousigant, P,Bourbeau, J,Menzies, D,Schwartzman, K(2004).Feasibility and reliability of health-related quality of life measurements among tuberculosis patients.Qual Life Res,13,653-65.
16. Ghisletta, P,Spini, D(2004).An introduction to generalized estimating equations and an application to assess selectivity effects in a longitudinal study on very old individuals.J Educ Behav Stat,29,421-37.
17. Harper, A,Power, M,Kuyken, W,Sartorius, N,Bullinger, M,Orley, J(1996).WHOQOL-BREF Introduction, Administration, Scoring, and Generic Version of the Assessment.Geneva:WHO.
18. Helbling, B,Overbeck, K,Gonvers, JJ(2008).Host-rather than virus-related factors reduce health-related quality of life in hepatitis C virus infection.Gut,57,1597-603.
19. Hunt, SM,McKenna, SP,McEwan, J(1989).The Nottingham Health Profile. Users Manual.Manchester:Galen Research and Consultancy.
20. Jang, Y,Hsieh, CL,Wang, YH,Wu, YH(2004).A validity study of the WHOQOL-BREF assessment in persons with traumatic spinal cord injury.Arch Phys Med Rehabil,85,1890-5.
21. Kelly, P(1999).Isolation and stigma: the experience of patients with active tuberculosis.J Community Health Nurs,16,233-41.
22. Kempen, GI,Ballemans, J,Ranchor, AV,van Rens, GH,Zijlstra, GA(2011).The impact of low vision on activities of daily living, symptoms of depression, feelings of anxiety and social support in community-living older adults seeking vision rehabilitation services.Qual Life Res,21,1405-11.
23. Lee, JJ,Wu, RL,Lee, YS,Wu, YC,Chiang, CY(2007).Treatment outcome of pulmonary tuberculosis in eastern Taiwan - experience at a medical center.J Formos Med Assoc,106,25-30.
24. Liao, CM,Hsieh, NH,Huang, TL(2012).Assessing trends and predictors of tuberculosis in Taiwan.BMC Public Health,12,29.
25. Long, NH,Johansson, E,Diwan, VK,Winkvist, A(2001).Fear and social isolation as consequences of tuberculosis in VietNam: a gender analysis.Health Policy,58,69-81.
26. Luh, KT(2011)。Taiwan Guidelines for TB Diagnosis and Treatment。Taipei:CDC Taiwan。
27. Marra, CA,Marra, F,Cox, VC,Palepu, A,Fitzgerald, JM(2004).Factors influencing quality of life in patients with active tuberculosis.Health Qual Life Outcomes,2,58.
28. McHorney, CA,Ware, JE, Jr,Raczek, AE(1993).The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs.Med Care,31,247-63.
29. Munch, Z,van Lill, SW,Booysen, CN,Zietsman, HL,Enarson, DA,Beyers, N(2003).Tuberculosis transmission patterns in a high-incidence area: a spatial analysis.Int J Tuberc Lung Dis,7,271-7.
30. Pasipanodya, JG,Miller, TL,Vecino, M(2007).Using the St. George respiratory questionnaire to ascertain health quality in persons with treated pulmonary tuberculosis.Chest,132,1591-8.
31. Spilker, B(ed.)(1996).Quality of Life and Pharmacoeconomics in Clinical Trials.Philadelphia:Lippincott-Raven.
32. WHO(1998).The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties.Soc Sci Med,46,1569-85.
33. Yang, SC,Kuo, PW,Wang, JD,Lin, MI,Su, S(2005).Quality of life and its determinants of hemodialysis patients in Taiwan measured with WHOQOL-BREF (TW).Am J Kidney Dis,46,635-41.
34. Yao, G,Chung, CW,Yu, CF,Wang, JD(2002).Development and verification of validity and reliability of the WHOQOL-BREF Taiwan version.J Formos Med Assoc,101,342-51.
35. Zeger, SL,Liang, KY,Albert, PS(1988).Models for longitudinal data: a generalized estimating equation approach.Biometrics,44,1049-60.