Available online 9 April 2024, 151789

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Higher need of continuing care services for patients discharged from hospitals with pulmonary tuberculosis, but many patients don't know that continuing care services.

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Patients prefer telephone follow-up for continuing care services.

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The services most needed by patients are health education guidance, especially pulmonary tuberculosis disease knowledge guidance.

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Compared to the original hospital medical personnel, the primary source of care information after discharge is a 14.806-point lower need for continuing care services in the local medical institutions.

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Continuing care service needs are positively associated with social support and not with readiness for hospital discharge.

AbstractObjective

To understand the relationship between the need for continuing care services and influencing factors, social support, readiness for discharge among discharged pulmonary tuberculosis (PTB) patients.

Methods

A cross-sectional study was conducted among 170 patients from a database of discharged patients with PTB from September 2023 to January 2024. A demographic and disease characteristics questionnaire, continuing care services basic modality questionnaire, continuing care services need questionnaire, the Social Support Rating Scale (SSRS), and the Readiness for Hospital Discharge Scale (RHDS) were used for this investigation. Univariate analysis and multiple linear regression analysis were used to analyze the associated factors.

Results

The mean total score for the need for continuing care services among patients with PTB discharged from the hospital was (121.61 ± 22.98). The dimension with the highest score was health education guidance need. Compared to the the original hospital medical personnel, the primary source of care information after discharge was the local medical institutions was statistically significant and negatively correlated with continuing care service need (P = 0.005). Social support was positively associated with demand for extended care services (P = 0.042).

Conclusion

Discharged PTB patients had a high degree of continuing care service need. Factors influencing the need for continuing care services are the primary source of care information after discharge was the local medical institutions, the social support. Medical staff need to provide targeted continuing care services based on relevant influencing factors to meet the discharge needs of patients.

Section snippetsBackground

Pulmonary tuberculosis (PTB) is an infectious disease in which Mycobacterium tuberculosis causes tuberculous lesions in the host's lung tissue, trachea, bronchus, or pleura. PTB is the most common type of TB. According to statistics, there were 10.6 million people with tuberculosis worldwide in 2021, making it the second leading cause of death from a single infectious agent (World Health Organization, 2022). PTB has the second highest incidence and mortality rate among Class A and Class B

Study design and participants

This study included 170 patients with PTB discharged from September 2023 to January 2024 from the tuberculosis department of a tertiary general hospital in Changsha city. The inclusion criteria for patients were as follows: (1) met the Diagnostic Criteria for Pulmonary Tuberculosis (WS 288 - 2017) in China(National Health and Family Planning Commission of the People's Republic of China, 2018); (2) were aged ≥18 years; (3) were hospitalized ≥3 days and discharged in accordance with medical

Demographic and disease characteristics

A total of 170 discharged PTB patients were included in this study. Among them, 46 (27.1 %) patients were treated for the first time, 124 (72.9 %) patients were retreated, their ages ranged from 18 to 82 (45.06 ± 17.90) years, and their length of hospitalization ranged from 3 to 120 (10.32 ± 12.97) days, as shown in Table 1.

Survey of basic modalities of continuing care services for patients with PTB discharged from the hospital

As shown in Table 2, telephone follow-up (28.6 %), outpatient visit (25.8 %), and online communication (13.3 %) were the top three modes of provision of continuing care. A

Discussion

Although some of the patients were aware of continuing care services during previous or current anti-tuberculosis treatment, most of them prioritized the cost of the service and refused to participate in continuing care services after discharge or reduced the frequency of participation. This study showed that 48.2 % of patients with PTB discharged from the hospital were completely unaware of continuing care services, and 68.2 % had never participated in continuing care services, reflecting a

Conclusion

This study showed that the need for continuing care services among PTB patients discharged from the hospital was high, as was the need for different modalities and contents. The primary source of care information after discharge is from the local medical institutions, and patients with low levels of social support,have low need for continuing care services. We recommend that clinical caregivers develop personalized continuing care services according to the influencing factors and patient needs,

Ethics statement

This study was approved by the ethics committee of Changsha Central Hospital Affiliated to University of South China (approval number: 2023-132). All procedures were conducted in strict accordance with the Declaration of Helsinki. All patients provided informed consent.

Funding

This study was supported by Hunan Provincial Natural Science Foundation of China (2021JJ70065).

CRediT authorship contribution statement

Jiani Wang: Writing – review & editing, Writing – original draft, Investigation, Data curation, Conceptualization. Qin Rao: Writing – review & editing, Investigation, Data curation. Lan Zhou: Writing – review & editing, Investigation. Lingling Xiang: Writing – review & editing, Investigation. Mingxia Xi: Writing – review & editing, Project administration, Methodology, Data curation, Conceptualization.

Declaration of competing interest

The authors have no conflicts of interest to declare.

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