J Nurs Acad Soc.
1996 Sep;26(3):697-708.
The Effect of Behavior Modification on Enhancing Patient Adherence to Tuberculosis Treatment Regimens
Abstract
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Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adher ence to tuberculosis treatment regimens. A random assignment, two-group (experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitaring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows: 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0. 01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03). 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, P=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.