目的:結核病是全球重要的健康問題之一,我國多年來結核病的防治雖有不錯的成果,但年死亡率每十萬人口5.81人,距離世界衛生組織所訂定結核病之控制標準:「結核病死亡率為每十萬人口2人以下」,尚有一段距離。由於未完成治療是影響國內結核病防治的重大因素,同時也增加防疫與治療上的困難,因此本研究希望藉由全國性之調查,了解造成肺結核患者未完成治療之因素。 方法:本研究對象為衛生署疾病管制局(CDC)2001年1~12月所登錄全國之肺結核病患,針對有完成治療肺結核患者及未完成治療的病患,利用分層隨機比例抽樣,並以電話訪問方式進行問卷調查。資料分析方面,以複迴歸分析(multiple regression analysis)探討影響肺結核病患整體治療滿意度之相關因素。最後利用羅吉斯迴歸分析(logistic regression analysis)探討影響肺結核患者是否完成肺結核治療之相關因素。 結果:在治療的過程中仍以服藥後感覺很不舒服及有副作用等因素為困擾肺結核病患之主要問題。在整體治療滿意度方面,對醫師的治療效果及服務態度滿意度越高者,其整體治療滿意度越高。在羅吉斯迴歸分析方面,曾因為罹患肺結核而更換工作或離職者其未完治機率較低;中等教育程度、中低收入者、治療期間有更換過醫院者、未規則服藥、曾中斷治療者、治療過程對生活相當有影響者則有較高的機率未完成治療。而病患因為瞭解服用藥物後的副作用,可能產生預先的抗拒心態,在沒有健全的心理建設下,亦會造成肺結核病患未完成治療。 結論與建議:由本研究結果可知藥物副作用、服藥遵從性、對肺結核疾病的認知及是否有固定就醫場所等都是影響肺結核病患是否完治的重要關鍵因素。因此本研究建議衛生主管機關:(1)宣導肺結核病患至指定醫療院所就醫;(2)鼓勵藥廠開發新藥,降低副作用或縮短療期;(3)改善治療結核病支付制度;(4)定期更新肺結核病患資料。對於醫師建議:(1)加強病患對疾病與療程的認知;(2)增進與病患家屬溝通,以提升家庭支持;(3)實施肺結核治療個案管理措施。對衛生所護士建議其應(1)參與肺結核相關衛教之在職教育;(2)增加訪視與關懷肺結核病患;(3)加強病患服藥遵從性。; Purpose: Tuberculosis is one of the important health issues in the world. The effects of prevention for tuberculosis were satisfied. However, the death rate of 5.81 per hundred thousand populations was still higher than the control standard rate defined by WHO that the tuberculosis death rate is less than 2 people per hundred thousand populations. Incomplete treatment is the important factor that increases the difficulty of tuberculosis’s prevention and treatment. This study would like to investigate the relative factors of failed treatment for TB patients. Method: The data were derived from CDC nationwide dataset of TB patients that registered in CDC from January to December in 2001. Proportional random sampling was applied to select TB patients. Structured questionnaires were used to interview TB patients by phone. Multiple regression analysis was conducted to explore the relative factors that influenced the patients’ satisfaction with treatment process and outcomes, and logistic regression analysis was applied to examine the factors that significantly affected tuberculosis patients. Results: The main problems for patients after taking medicine were drug’s side effect and uncomfortable. For the patients’ satisfaction with TB treatment, satisfied with treatment effect, and satisfied with physician’s manner and attitude would feel more satisfied in general. According to the logistic regression analysis, patients who had the experience of changing jobs or turnover during treatments had lower failed rates. Patients had the experience of changing hospitals during treatments, middle level education, lower family income, taking medicine irregularly, having interrupted treatment, and having great ill effects on life during treatments that would increase to have failed treatments. When patients knew the information of drug’s side effect and hadn’t stronger psychological fortification and lacked the awareness of TB, it would raise TB patients not to be cured. Conclusion and recommendation: The results showed that drug’s side effect, compliance, the awareness of TB and regular place of care were the key factors for TB patients to cure their TB disease. Based on the results, the study provides some recommendations to health policy decision makers as follows: (1) advocate the concept of going to the fixed hospitals/clinics for TB treatments; (2) encourage pharmaceutical factory to invent new TB medicine with lower side effect or shorter treatment course; (3) recommend the Bureau of National Health Insurance to modify the payment system for TB treatment; (4) reconfirm the TB dataset correctly. There are some recommendations to physicians as follows: (1) enhance the awareness of TB and treatment course to TB patients; (2) improve the communication with patients’ families and enhance family’s support; (3) implement case management program for TB patients. The recommendations to public health nurses are the following: (1) to attend in-service education about TB education; (2) incr