الفهرس 
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Abstract
Tuberculosis (TB) is an airborne bacterial infection caused by the organism Mycobacterium tuberculosis that primarily affects the lungs, although other organs and tissues may be involved. It is not easy to become infected with tuberculosis.Most infected people have latent TB, meaning they have the tuberculosis germs in their bodies, but their immune system protects them from becoming sick and they are not contagious. TB can usually be treated and cured if person take medicine as directed. (American lung association, 2018)
Self-care is defined as the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being. Self-care practices include healthy eating, physical activity, adequate rest, personal hygiene, social interaction, stress management, staying spiritually connected, compliance with treatment and compliance with follow up visit (Marilyn Parker, 2015).
Community health nurses spend the most time with patients, so when empowered with knowledge on treating TB it is a benefit to all because this leads to good adherence, good outcomes, a healthy community for all, and through this, they will reach the goal strategy – a TB-free world in 2030 (Union Scientific, 2017).
Significance of the study:
TB is preventable disease through health awareness of people about preventive measure and immunization. This will contribute in decreasing high cost of treatment. The importance of this study is to assess the knowledge, attitude, and self-care practices of patients toward TB
In EYGPT according to WHO statistics; the prevalence rate of TB in Egypt was 23 per 100, 000 people according to the World Health Organization estimate in 2017, while the incidence rate was 13 per 100, 000 people. Screening, diagnosis, notification, and registration of TB cases were implemented all over Egypt according to the National TB Strategy of the National Tuberculosis Control Program (WHO, 2018).
Aim of the study:
The aim of this study was to assess self-care practices of TB patients through:
1. Assessing patient’s health condition.
2. Assessing patient’s knowledge about TB disease.
3. Assessing self-care practices toward TB disease.
Research Questions:
1. Is there a relation between patients’ self-care practices and their health condition?
2. Is there a relation between patient’s knowledge about TB disease and their demographic data?
3. Is there a relation between patients’ self-care practices toward TB disease and their demographic data?
Subject and methods
Research design:
Descriptive study design was used.
Research Setting:
The study was carried out in 10 chest dispensaries clinics [Barket Elsabe, Tala, Shebin El Kom, Quesina, Menouf, El Bagor, and Sers El Layan, El shada(2) Clinic, Ashmoon] affiliated to Menoufiya Governorate.
Sampling:
Type: A purposive sample was used.
Size: All patients attending chest dispensaries clinics at the time of data collection.).
Sampling technique:
The technique of the sample was be carried out as follows:
All the subjects who met the set of inclusive criteria and attended, the pre-mentioned setting only were involved in this works, the investegator completed the data collection format from subject after explaining the aim of this study and once completed went to the next subject and so on until finishes all subjects attended in that day.
Technical design
The following tools were used for data collection of study:
• First tool:
First tool: Interviewing questionnaire was developed by the investigator based on the recent related literature review, expert’s opinion and was written in the simple Arabic language to assess:
Part one: Socio-demographic characteristic such as age, gender, educational level, occupation, marital status,… etc.
Part two: the past and current history of respiratory system status information such as treatment adherence, reasons for non-adherence to treatment, factors associated with treatment failure, duration of treatment and knowledge on TB transmission, signs and symptoms, complication,...etc.
Main questions were included dealing with knowledge related practice are isolation technique and treatment system, preventive methods, follow up schedule and handling body secretion, The questionnaire was include also participant’s knowledge toward their common physical symptoms of their disease such as: loss of weight, chest pain, cough, general fatigue, fever, muscle cramps, diarrhea, constipation, skin irritation …etc.
Second tool: Self-Care Checklist
An checklist, was designed to assess the study participants practices regarding their self-care management that include the following items: healthy eating, physical activity, adequate rest, personal hygiene, social interaction, stress management, staying spiritually connected, compliance with treatment and compliance with follow up visit this checklist adapted from The Happy Healthy Nonprofit: Impact with Burnout by (Beth Kanter and Aliza Sherman, 2016) and edited to be suitable for the research.
Content Validity:
Tools of the study were reviewed by five expertises in community health nursing to test the content validity.
Operational design
Pilot study:
Was conducted for 5% of patients according to the result of the data analysis items. Correction, omissions and additions were followed as needed.
Field work:
Data collection was conducted by interviewing patients who were fulfill the study criteria, attended the pre-mentioned chest dispensaries, Menoufiya governorate; this was done for a period of 6 months, 3 days per week (Sunday, Monday and Wednesday) this was done through the working hours 9 am to 1 pm.
Administrative Design:
An official permission was obtained from administrators of 10 chest dispensaries clinics in Menoufiya Governorate.
Ethical considerations:
The study was conducted with careful attention to ethical standards of research and rights of the participants include-
• Informed consent
• Anonymity and confidentiality
• Scientific honesty
Statistical Design:
The data were synthesized, analysed, and presented in numbers, percentages, tables, figures, and diagrams. Using the statistical package for social science (SPSS) to evaluate various variables under study, an appropriate statistical test was used.
Data Analysis:
The collected data were tabulated and summarized. Data were then being computerized and analysed using the appropriate descriptive and inferential statistical tests to test the research hypnosis.
Results& findings:
Findings of the current study can be summarized as:
• There were (78.2%) of the patients their ages were between 26-65 years, (59.1%) of patients were males, Regarding to educational levels (39.1%) of patients were secondary education. As for marital status results showed that (60%) of patients were married. Results also showed that (62.2%) of patients were not working. Results also showed that (58.2%) of the patients were living in rural area. Results also showed that (80.9%) of the patients had insufficient income.
• As regards Total level of the general knowledge about TB disease results showed that all patients knew that TB is contagious while (54.5%) knew that TB is a very dangerous disease and (62.8%) were not know the different types of TB and (53.6%) knew that the TB cause is bacteria.
• There were (80.9%) of patients were always committed to taking the medicine on time. Results showed also that (51.9%) of patients sometimes committed to the timetable for follow up. Results showed also that (71.8%) of patients were never stopped treatment when didn’t feel better.
• There were not significant relations between all types of self-care practices of patients and their health condition.
• There were significant relations between self-care practices including (physical, mind, emotions, spiritual), practices toward work and money, commitment to TB treatment) and level of patient knowledge about TB disease while there weren’t significant relations between (stress management practices, social interaction, environmental practices) and knowledge level.
Conclusion:
The current study findings concluded as the following:
• It illustrated that slightly more than three quarters of the patients their ages were between 26-65 years, more than half of patients were males, regarding to educational levels less than half of patients were secondary education. Results also showed that more than two thirds of the patients had insufficient income.
• The current study findings illustrated that one of patients had bad health condition while less than half of them had good health condition and slightly less than two thirds had very good health condition.
• As regards sources of information that illustrated that more than three-quarters of the patients their sources of information about TB disease were health workers.
• The current study findings illustrated less than quarter of patients had poor knowledge about TB disease while slightly less than half of them had average knowledge and more than third had good knowledge.
• There were significant relations between total level of patients practice and gender while there weren’t significant relation between (commitment to TB treatment, environmental practices) and gender.
Recommendations
In the light of the study findings, the following recommendations were suggested:
• Early detection of TB patient through screening programme.
• More attention should be given to TB patients and their families.
• Raise families’ awareness regarding method of dealing with their TB patients.
• Planning and developing a health educational program for TB patients who should informed about all aspects regarding prevention and care of them through chest dispensaries clinics.
• Improving the patient knowledge and practice toward TB disease through mass media such as posters, booklets, television and newspapers.
• Further studies should be conducted to improve patient knowledge and practices for proper caring and proper treatment.
• Further studies should be conducted to include large sample for generalization of results.