DETERMINANT OF COMPLIANCE WITH TUBERCULOSIS TREATMENT PATIENT’S PUBLIC HEALTH CENTER IN PALEMBANG CITY, 2010

Abstract

Background : Tuberculosis (TB) is still a major problem worldwide (WHO,2010). One third of the world population are infected by Mycobacterium Tuberculosis. Approximately 9 million of new cases are identified and 2–2 million people died because of this desease every year. WHO in an annual report on Global TB Control 2009 stated that Indonesia is the third country in the world with tuberculosis problem after India and China. Tuberculosis is a communicable infection desase that causes many death amongst all age. Up to present the tuberculosis rehabilitation program in Indonesia is still far away from expected outcomes, as same as in Palembang. One of the main cause is high rate of incompliance to treatment . Thereore, the compliance to treatment is the most priority.

Method : The purpose of this study was to determine variables influence the compliance of tuberculosis patients to treatment in Indonesia .The study took place in 36 public health center locations in Palembang City. The design of this study was cross sectional from wich the information about the compliance of the tuberculosis patients are measured simultaneously with the orther perception of attitudes.The datas were analysed using the Multiple Logistic Regression in order to find the most proper (fit), simple (parsimonious), and right (robust) model in order to describe the relationship between the outcome variable and set predictor variables and one set predictor variables . Two hundred eight subjects parcipated in the study of wich 66,8% of the subjects are identified as having incompliance attitude. Based in the findings the study also propose a predicted model of TB patient’s compliance to the treatment.

Results : Multiple Logistic Regression analyses showed that the predictor of the patient’s compliance to treatment are perceived self efficacy and perceived barriers to action (spesific behaviour), knowledge of the TB disease (prior behavior) and health care provider support (influences interpersonal). Perceived self efficacy is the main determinant. Patients who had perceived self efficacy are potentially to be comply to treatment 27,650 times. Patients who had knowledge of the TB disease have potentially to be comply to treatment 8,930 times. Patients who din’t have percieved barries to action have potentially to be comply 6,529 times, where as patients who had support from the health provider are potentially to be comply to treatment 5,509 times .

Conclusion : The incompliance patient are caused by nothing perceived self efficacy 96%. If all TB patient have good perceived self efficacy, the number of incompliance can be reduced from 66,8% to 21,6%. The second variable is knowledge of the TB desease showed that 88,7 % of TB patients who had incompliance to the treatment is caused by lack of knowledge the disease. If all TB patients had good knowledge of the TB desease, the rate of incompliance patients can be redused from 66,8 % to 16,97%.The third variable is the perceived barries to action ; it is found that 84,7% of patients who had incompliance to the treatment is caused by the perceived barriers to action. If all patients didn’t have barriers to action, the number of incompliance can be reduced from 66,8% to 23,65%. The incompliance patients are caused by no support from health provider 81,8% if all TB patients got suffcient support from health care provider during treatment, the number of incompliance patients can be reduced from 66,8 % to 29,46%.

It is recommended that treatment model of TB patient’s compliance is used as a method to promote and prevent contageous disease especially TB . Health provider has roles to patient education and empower community partipation by facilitating the establishment of self-help group of TB patients. During the activities of the self-help group, TB patients will share their knowledge and experiences thus can improve the motivation, self efficacy, awareness of sign and symptoms of TB disease and decrease the perceived barries to action.

Keyworsd : Compliance, Tuberculosis, Self Help Group