The effects of the enablers incentive package on the quality of life among tuberculosis patients receiving DOTS in the Gambia

促成獎勵措施對於甘比亞接受都治治療的肺結核病人生活品質影響之研究

10.6288/TJPH.201804_37(2).106127

謝朗明(Lamin M. Ceesay)；黃嵩立(Song-Lih Huang)；楊振昌(Chen-Chang Yang)；顏璧梅(Pi-Mei Nancy Yen)

Gambia ； health-related quality of life ； incentives ； tuberculosis ； 甘比亞 ； 健康相關生活品質 ； 誘因 ； 肺結核

台灣公共衛生雜誌

37卷2期（2018 / 04 / 15）

182 - 195

英文

Objectives: The purpose of this research was to explore the quality of life among tuberculosis patients in the Gambia and assess the effects of the enablers package on it. Methods: A cross-sectional study was conducted among patients receiving anti-TB treatment for at least two weeks in the Gambia. Health-related quality of life was assessed using the WHOQOL-BREF questionnaire through face-to-face interview. The mean overall and domain-specific scores of the WHOQOL-BREF were compared for recipients and non-recipients of the enablers package. Multiple linear regression analyses were employed to identify predictors of a better quality of life. Results: Receipt of the enablers package had a positive association with the overall quality of life (p＜0.0001) and all domain-specific quality of life scores except that of the social domain. Multiple linear regression analyses revealed that the receipt of incentives, female gender, and urban residence had positive significant impacts on the overall quality of life. Conclusions: The results of this study mark the beginning of the understanding of quality of life studies in the Gambia, especially among TB patients. Further research is warranted to explore the needs of TB patients in order to improve their quality of life.

目標：本研究目的在探討甘比亞肺結核病患的生活品質及就醫時是否接受促成獎勵措施（enablers package）對於病人健康相關生活品質的影響。方法：本研究利用橫斷式研究，以至少接受兩週以上肺結核治療的肺結核病人為研究對象。利用世界衛生組織健康相關生活品質滿意度問卷進行面對面訪談，以瞭解其健康相關生活品質之狀況，並比較接受及未接受促成獎勵措施的兩組病人的整體及不同範疇的健康相關生活品質平均分數之差異。最後以複線性迴歸模式分析探討可能與較佳的生活品質有關的預測因子。結果：有接受促成獎勵措施者較無接受相關措施者有顯著較高的整體健康相關生活品質（p＜0.001）；且與生理、心理與環境等範疇之健康相關生活品質也都有顯著的正相關。在複線性迴歸模式分析中，有接受治療的誘因（促成獎勵措施）、女性及居住在城市者有顯著較高的整理健康相關生活品質。結論：本研究結果為首次瞭解甘比亞肺結核病人的健康相關生活品質。未來需要更進一步的研究以瞭解肺結核病人的需求，並提升該族群的生活品質。

1. Gamb ia Gover nment. The Gambia Country Common Assessment, 2015. Banjul: United Nations Development Group (UNDG), 2015.
2. Centers for Disease Control and Prevention. Health related quality of life. Available at: http://www.cdc.gov/hrqol/concept.htm. Accessed November 22, 2017.
3. Gambia Bureau of Statistics (GBoS). Integrated Household Survey: Income and Expenditure - Poverty Assessment 2010. Banjul: GBoS, 2012.
4. The World Bank. Gambia - An Assessment of Poverty. Gambia: The World Bank, 1993; 41.
5. Al-Qahtani, MF,Mahalli, AAE,Al Dossary, N,Al Muhaish, A,Al Otaibi, S,Al Baker, F(2014).Health-related quality of life of tuberculosis patients in the Eastern Province, Saudi Arabia.J Taibah Univ Med Sci,9,311-7.
6. Asnani, MR,Lipps, GE,Reid, ME(2009).Utility of WHOQOL-BREF in measuring quality of life in sickle cell disease.Health Qual Life Outcomes,7,75.
7. Atif, M,Sulaiman, SA,Shafie, AA,Ali, I,Hassali, MA,Saleem, F(2012).WHO guideleines for treatment of tuberculosis: the missing links.Int J Clin Pharm,34,506-9.
8. Babikako, HM,Neuhauser, D,Katamba, A,Mupere, E(2010).Feasibility, reliability and validity of health-related quality of life questionnaire among adult pulmonary tuberculosis patients in urban Uganda: cross-sectional study.Health Qual Life Outcomes,8,93.
9. Barker, LR(ed.),Burton, JR(ed.),Zieve, PD(ed.)(2007).Principles of Ambulatory Medicine.Phidelphia:Lippincott Williams & Wilkins.
10. Bauer, M,Leavens, A,Schwartzman, K(2013).A systematic review and meta-analysis of the impact of tuberculosis on health-related quality of life.Qual Life Res,22,2213-35.
11. Brown, J,Capocci, S,Smith, C,Morris, S,Abubakar, I,Lipman, M(2015).Health status and quality of life in tuberculosis.Int J Infect Dis,32,68-75.
12. Cassileth, BR,Lusk, EJ,Strouse, TB(1984).Psychosocial status in chronic illness: a comparative analysis of six diagnostic groups.N Engl J Med,311,506-11.
13. Chang, B,Wu, AW,Hansel, NN,Diette, GB(2004).Quality of life in tuberculosis: a review of the English language literature.Qual Life Res,13,1633-42.
14. Cramm, JM,van Exel, J,Møller, V,Finkenflügel, H(2010).Patient views on determinants of compliance with tuberculosis treatment in the eastern cape, South Africa: an application of q-methodology.Patient,3,159-72.
15. Dhuria, M,Sharma, N,Ingle, GK(2008).Impac to tuberculosis on the quality of life.Indian J Community Med,33,58-9.
16. Eichler, R,Levine, R,the Performance-Based Incentives Working Group(2009).Performance Incentives for Global Health: Potentials and Pitfalls.Washington:Center for Global Development.
17. Guo, N,Marra, CA,Marra, F,Moadebi, S,Elwood, RK,FitzGerald, JM(2008).Health state utilities in latent and active tuberculosis.Value Health,11,1154-61.
18. Guo, N,Marra, F,Fitzgerald, JM,Elwood, RK,Marra, CA(2010).Impact of adverse drug reaction and predictivity of quality of life status in tuberculosis.Eur Respir J,36,206-8.
19. Guo, N,Marra, F,Marra, CA(2009).Measuring healthrelated quality of life in tuberculosis: a systematic review.Health Qual Life Outcomes,7,14.
20. Heijnders, ML(2004).The dynamics of stigma in leprosy.Int J Lepr Other Mycobact Dis,72,437-47.
21. Hill, PC,Stevens, W,Hill, S(2005).Risk factors for defaulting from tuberculosis treatment: a prospective cohort study of 301 cases in the Gambia.Int J Tuberc Lung Dis,9,1349-54.
22. Kastien-Hilka, T,Abulfathi, A,Rosenkranz, B,Bennett, B,Schwenkglenks, M,Sinanovic, E(2016).Health-related quality of life and its association with medication adherence in active pulmonary tuberculosis- a systematic review of global literature with focus on South Africa.Health Qual Life Outcomes,14,42.
23. Khan, A,Walley, J,Newell, J,Imdad, N(2000).Tuberculosis in Pakistan: socio-cultural constraints and opportunities in treatment.Soc Sci Med,50,247-54.
24. Kisaka, SM,Rutebemberwa, E,Kasasa, S,Ocen, F,Nankya-Mutyoba, J(2016).Does health-related quality of life among adults with pulmonary tuberculosis improve across the treatment period? A hospital-based cross sectional study in Mbale Region, Eastern Uganda.BMC Res Notes,9,467.
25. Kittikraisak, W,Kingkaew, P,Teerawattananon, Y(2012).Health related quality of life among patients with tuberculosis and HIV in Thailand.PLoS One,7,e29775.
26. Louw, J,Peltzer, K,Naidoo, P,Matseke, G,Mchunu, G,Tutshana, B(2012).Quality of life among tuberculosis (TB), TB retreatment and/or TB-HIV co-infected primary public health care patients in three districts in South Africa.Health Qual Life Outcomes,10,77.
27. Lutge, E,Lewin, S,Volmink, J,Friedman, I,Lombard, C(2013).Economic support to improve tuberculosis treatment outcomes in South Africa: a pragmatic clusterrandomized controlled trial.Trials,14,154.
28. Lutge, EE,Wiysonge, CS,Knight, SE,Sinclair, D,Volmink, J(2015).Incentives and enablers to improve adherence in tuberculosis.Cochrane Database Syst Rev,9,CD007952.
29. 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.
30. Mazaheri, M(2010).Overall, and specific life satisfaction domains: preliminary Iranian students norms.Iran J Public Health,39,89-94.
31. Rajeswari, R,Muniyandi, M,Balasubramanian, R,Narayanan, PR(2005).Perceptions of tuberculosis patients about their physical, mental and social well-being: a field report from south India.Soc Sci Med,60,1845-53.
32. Ravens-Sieberer, U,Bullinger, M(1998).Assessing healthrelated quality of life in chronically ill children with the German KINDL: first psychometric and content analytical results.Qual Life Res,7,399-407.
33. Rolfes, L,van Hunsel, F,Taxis, K,van Puijenbroek, E(2016).The impact of experiencing adverse drug reactions on the patient's quality of life: a retrospective cross-sectional study in the Netherlands.Drug Saf,39,769-76.
34. Sanneh, AF,Pollock, JI(2010).Comparison of Pulmonary TB DOTS clinic medication before and after the introduction of daily DOTS treatment and attitudes of treatment defaulters in the Western Division of the Gambia.Afr Health Sci,10,166-71.
35. Skevington, SM,Lotfy, M,O'Connell, KA,WHOQOL Group(2004).The World Health Organization's WHOQOLBREF quality of life assessment: psychometric Properties and results of the international field trial. A report from the WHOQOL group.Qual Life Res,13,299-310.
36. The Joint United Nations Programme on HIV/AIDS (UNAIDS)(2005).Intensifying HIV Prevention: A UNAIDS Policy Position Paper.Geneva:UNAIDS.
37. United Nations Development Program=UNDP(2013).Human Development Report 2013. The Rise of the South: Human Progress in a Diverse World.New York, NY:UNDP.
38. WHO(2016).Global Tuberculosis Report 2016.Geneva:WHO.
39. WHO(2015).Global Tuberculosis Report 2015.Geneva:WHO.
40. WHO(1997).WHOQOL: Measuring Quality of Life.Geneva:WHO.
41. WHO(1996).WHOQOL-BREF: Introduction, Administration and Scoring.Geneva:WHO.
42. WHO(2006).The Global Plan to Stop TB 2006-2015.Geneva:WHO.
43. Wilhelm, K(ed.)(2008).Encyclopedia of Public Health.Netherlands:Springer.
44. Yip, KS(2003).Gender differences in mental illness in Hong Kong.Adm Policy Ment Health,30,361-8.