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背景:越南胡志明市目的:确定国家结核病规程(NTP)中病人的初始不合作程度、原因以及初始不合作后的求医行为和在其它医疗机构接受治疗的情况。方法:对2000年在NTP中被诊断为涂阳肺结核但未在NTP登记治疗的病人进行问卷调查。结果:初始不合作率为8.3％;79％的不合作者与NTP的工作程序或治疗策略有关,17.5％则是由于病人对结核病以及/或治疗必要性的知识不足所致。65％的病人在初始不合作后到其它医疗机构接受了抗结核治疗,其中74％在全私人机构接受治疗。 结论:初始不合作主要是由于一些病人对于NTP的工作程序和/或治疗策略的误解而产生的。在初始不合作后大多数病人在私人诊所接受治疗。NTP需要增进病人对治疗策略的理解,提供亲切的服务使更多病人得到治疗,减少病人在私人诊所接受不标准治疗带来的风险。
Background: Ho Chi Minh City, Vietnam Purpose: To determine the initial level of patient nonconformities in the National Tuberculosis Program (NTP), the reasons for the initial uncooperative medical treatment and treatment in other medical institutions. Methods: A questionnaire was conducted on patients who were diagnosed as having smear positive pulmonary tuberculosis in NTP in 2000 but not enrolled in NTP. Results: The initial rate of non-cooperation was 8.3%. 79% of non-partners were related to NTP’s working procedure or treatment strategy, while 17.5% were due to lack of knowledge about tuberculosis and / or the need for treatment. Sixty-five percent of patients received antituberculosis treatment at other institutions after initial disagreement, of which 74% were treated in private-owned institutions. CONCLUSIONS: The initial uncooperativeness was mainly due to the misunderstanding of some patients’ work procedures and / or treatment strategies for NTPs. Most patients are treated in private clinics after initial disobedience. NTP needs to improve patient understanding of treatment strategies and provide cordial services to treat more patients and reduce the risk of patients receiving nonstandard treatment in private clinics.