Delay in Seeking Treatment and Adherence to Tuberculosis Medication Therapy in Russia

2.50
Hdl Handle:
http://hdl.handle.net/10755/160010
Type:
Presentation
Title:
Delay in Seeking Treatment and Adherence to Tuberculosis Medication Therapy in Russia
Abstract:
Delay in Seeking Treatment and Adherence to Tuberculosis Medication Therapy in Russia
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2007
Author:Woith, Wendy, PhD, RN
P.I. Institution Name:Mennonite College of Nursing at Illinois State University
Contact Address:Nursing, 208 Edwards Hall, Normal, IL, 61790-5810, USA
Co-Authors:J.L. Larson, A. Miller, and K. Norr, Nursing, University of Illinois at Chicago, Chicago, IL and L. Ivanov, Nursing, University of North Carolina, Greensboro, NC
Tuberculosis (TB) is a growing global problem, especially in high burden countries such as Russia, and is fueled by delay in seeking treatment and nonadherence to prescribed medications. Stigma and illness representation (a person's mental model of illness) affect treatment seeking and adherence. Five attributes comprise illness representation: identity (the self-diagnosis given a set of symptoms, measured by the number of symptoms an individual associates with a disease), timeline, consequences, control/cure, and cause. Data were analyzed from 105 participants being treated for active pulmonary TB in clinics located in the Vladimir region of Russia. Dimensions of stigma measured were social rejection, financial security, internalized shame, and social isolation. Dimensions of illness representation included the five attributes listed above. Symptoms most frequently reported by subjects included fatigue, night sweats, weight loss, and breathlessness, which differed from the persistent cough, fever, weight loss, and night sweats described in medical literature and other studies. Persistent cough was reported by 45.7% of participants, but only 26.7% identified this as related to TB. Only four subjects suspected TB based on their symptoms; 60% believed they had other respiratory infections. Multiple regression analyses were used to determine whether stigma and illness representation were predictors of delay adherence. Only identity was a significant predictor of delay, suggesting that those experiencing more symptoms were more likely to delay seeking treatment. Financial insecurity demonstrated a negative relationship to adherence, indicating that those who experienced financial hardship or job loss were less likely to adhere to prescribed medications. Subjects in this study were more adherent when they experienced perceived stigma. Illness representation was not found to be a predictor of adherence. A more accurate illness representation of TB could shorten delay and potentially reduce morbidity and mortality, as could stressing the significance of commonly experienced symptoms that are not generally associated with TB for this population. Results of this study point to the need for broad, culturally-specific patient, family, and community education programs.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleDelay in Seeking Treatment and Adherence to Tuberculosis Medication Therapy in Russiaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160010-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Delay in Seeking Treatment and Adherence to Tuberculosis Medication Therapy in Russia</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Woith, Wendy, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mennonite College of Nursing at Illinois State University</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Nursing, 208 Edwards Hall, Normal, IL, 61790-5810, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">wlwoith@ilstu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">J.L. Larson, A. Miller, and K. Norr, Nursing, University of Illinois at Chicago, Chicago, IL and L. Ivanov, Nursing, University of North Carolina, Greensboro, NC</td></tr><tr><td colspan="2" class="item-abstract">Tuberculosis (TB) is a growing global problem, especially in high burden countries such as Russia, and is fueled by delay in seeking treatment and nonadherence to prescribed medications. Stigma and illness representation (a person's mental model of illness) affect treatment seeking and adherence. Five attributes comprise illness representation: identity (the self-diagnosis given a set of symptoms, measured by the number of symptoms an individual associates with a disease), timeline, consequences, control/cure, and cause. Data were analyzed from 105 participants being treated for active pulmonary TB in clinics located in the Vladimir region of Russia. Dimensions of stigma measured were social rejection, financial security, internalized shame, and social isolation. Dimensions of illness representation included the five attributes listed above. Symptoms most frequently reported by subjects included fatigue, night sweats, weight loss, and breathlessness, which differed from the persistent cough, fever, weight loss, and night sweats described in medical literature and other studies. Persistent cough was reported by 45.7% of participants, but only 26.7% identified this as related to TB. Only four subjects suspected TB based on their symptoms; 60% believed they had other respiratory infections. Multiple regression analyses were used to determine whether stigma and illness representation were predictors of delay adherence. Only identity was a significant predictor of delay, suggesting that those experiencing more symptoms were more likely to delay seeking treatment. Financial insecurity demonstrated a negative relationship to adherence, indicating that those who experienced financial hardship or job loss were less likely to adhere to prescribed medications. Subjects in this study were more adherent when they experienced perceived stigma. Illness representation was not found to be a predictor of adherence. A more accurate illness representation of TB could shorten delay and potentially reduce morbidity and mortality, as could stressing the significance of commonly experienced symptoms that are not generally associated with TB for this population. Results of this study point to the need for broad, culturally-specific patient, family, and community education programs.</td></tr></table>en_GB
dc.date.available2011-10-26T22:32:30Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:32:30Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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