Assessment of self-management behavior and psychological adjustment practices among drug-sensitive tuberculosis patients at BRAC DOTS TB Center in Dhaka city: a cross-sectional study

Abstract

Introduction: the study used a cross-sectional study design to assess the self-management behaviors and self-efficacy practices of drug-sensitive TB (DS-TB) patients at the BRAC TB DOTS center Kamrangirchar located in Dhaka South City Corporation (DSCC). The primary goal of this study was to assess and evaluate DS-TB patient's self-management behaviors and psychological adjustment practices with a focus on socio-demographic factors. Method: The study was conducted among the 121 DS-TB patients with validated tools self-management scale for tuberculosis patients (SMSTP) & tuberculosis self-efficacy scale (TBSES). The study tool consisted of 24 questions within 4 domains including adherence to treatment, support behavior, disease transmission prevention behavior, and psychological adjustment. Data analysis was conducted using descriptive and inferential statistics including chi-square and t-tests to examine the associations between self-management behaviors, self-efficacy, and socio-demographic characteristics. Findings: The study found variability across each domain of self-management behaviors and self-efficacy practices. The findings indicate the majority of the participants (51.1%) have moderate self-management behaviors followed by 25.7% with low self-management behaviors and 23.1% with high self-management behaviors. Gender-based findings were particularly significant, with females exhibiting moderate and higher self-management 80.6% compared to male patients 66.7%. In addition, education level and occupation of the patients have also been found to be influencing factors, 83.54% of patients with secondary or higher education have moderate and high self-management compared to 57.14% uneducated or primary education completed. Students 94.12% and homemakers 82.05%, have higher self-management behaviors. Additionally, larger household sizes impact the psychological adjustment negatively as 76.92% of patients with 7 or more family members have lower psychological adjustment score. Conclusion: The study found gender as one influencing factor that is important to be considered for gender-specific interventions addressing health education, mental health support, and community-based awareness to improve the effectiveness of the DOTS intervention through self-management behaviors and self-efficacy practices in urban Bangladesh. The findings emphasize the need for community-based interventions and policy development to address the gap in self-management and psychological adjustment to achieve the targeted goal of the End TB strategy and National Tuberculosis Program (NTP).