科研之友
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摘要
objective: to evaluate the use of family members as supervisors of directly observed therapy (dot) in patients with tuberculosis. methods: this was a prospective descriptive study involving patients diagnosed with pulmonary tuberculosis. the sample comprised 98 patients. a standardized protocol was implemented in order to train the patient and their families. after the training, the patient was allowed to choose either a family member or a health care worker as a supervisor. absolute and relative frequencies were used in descriptive data analysis. results: a family member supervisor was chosen by 94 patients (96%). the cure rate was 99%. the partner was chosen by 49% of the patients, and other family members were chosen by 28%. the heath care team needed to take over dot in 3% of the cases. regular attendance at follow-up appointments was 67%. it was observed that 24% of the problems in this dot model referred to the family supervisor forgetting to administer the medication or to the patient forgetting to take it; 39% of the patients forgot to take the medication for one day, and 31% forgot to take it for two days. there was change of supervisor in 9% of the sample, medication was lost by the patient sometime during treatment in 9%, and patient drug intolerance occurred in 8%. conclusions: dot supervised by a family member has proven an effective and low-cost technique. however, compliance is not due to one single factor but to the combination of strategies adopted: bus passes; educational measures and especially the individualized approach.
