Abstract
The objective of this qualitative study was to study the adaptation to illness of tuberculosis patients and develop recommendations for family and social support of the
patients. Purposive sampling was carried out by in-depth interviews of registered AFBpositive pulmonary tuberculosis patients who were treated in Chaingyuen Hospital and
lived in Chaingyuen district. It also included in-depth interviews of the families, neighbors, and health volunteers, as well as the local governor, and health officer. Focus group
discussion was conducted among three groups of neighbors, families and cousins of tuberculosis patients; there were four cases of non-participatory observers in the patients’
families. The results of this study show that, in the first two months of treatment, the
patients required physical and psychological adaptation because of worring disease progression and drug side effects, which made them reduce their activities. They also needed
support from others, which lowered their self esteem. After the first two months the
patients felt better owing to their improving health, and the normal activity which gave
them confidence in the treatment and boosted their self esteem. Although most of the
patients could adapt to the role-functioning aspects, they still helped themselves and
sought the support of others appropriately. One-third of the patients sought alternative
treatment, especially with Thai herbs, without addressing financial problems. For social
support most patients were given good care and love by their families and the community with regard to finance, work, using utensils and providing information on the disease, all of which helped the patients. The patients were satisfied with the treatment
service received from the national health insurance system despite the lower number of
homevisits allowed under related guidelines. The health officer therefore followed up by
telephone instead of making homevisits, which showed that local government authorities can play a role in homevisits. Based on this study, we recommend that the authorities
involved should consider develping community networks and creating a referral system
for patient support, providing knowledge about tuberculosis to the community through
appropriate channels, for example, community radio, and developing a home visit system to meet establihed standards, and make continuous evaluation.
