Abstract:

Objective: To investigate the status quo and influencing factors of family functioning of patients with drug-resistant tuberculosis (DR-TB). Methods: A total of 300 DR-TB patients hospitalized in the Department of Tuberculosis at Shanghai Pulmonary Hospital, Affiliated to Tongji University, from October 2023 to October 2024 were selected. Family functioning was assessed using the Family Assessment Device (FAD). General demographic and clinical data of patients were collected. Multivariable logistic regression analysis was conducted to analyze the influencing factors of family functioning. Results: The average total FAD score of the 300 patients was (136.56±10.24), with subscale average scores as follows: communication (20.35±2.42), problem-solving (12.25±2.13), roles (25.47±2.50), behavioral control (21.31±2.04), affective responsiveness (14.91±2.24), affective involvement (17.43±2.33), and general functioning (27.62±3.11). Multivariable logistic regression analysis revealed that age ≥60 years (OR=3.739, 95%CI: 1.331-10.510), being unmarried (OR=2.362, 95%CI: 1.189-4.691), and PHQ-9 score ≥5 (OR=2.644, 95%CI: 1.358-5.149) were risk factors for impaired family functioning in DR-TB patients. In contrast, educational level being high school/technical secondary school (OR=0.113, 95%CI: 0.052-0.243), college or higher (OR=0.060, 95%CI: 0.023-0.153), medical insurance coverage (OR=0.139, 95%CI: 0.042-0.463), monthly household income >5000 yuan (OR=0.633, 95%CI: 0.471-0.850), and SF-36 score ≥80 (OR=0.611, 95%CI: 0.474-0.789) were protective factors. Interaction analysis demonstrated additive interactions between age and education level (RERI (95%CI): 1.809-3.143; AP (95%CI):0.313-0.462; S (95%CI):1.533-2.152), age and monthly household income (RERI (95%CI): 0.931-1.353; AP (95%CI): 0.355-0.543; S (95%CI):1.821-10.922), age and PHQ-9 score (RERI (95%CI):0.053-0.268; AP (95%CI):1.058-1.762; S (95%CI): 0.148-0.670), age and SF-36 score (RERI (95%CI):1.063-1.804; AP (95%CI): 0.152-0.721; S (95%CI):1.063-1.804), education level and monthly household income (RERI (95%CI):0.057-0.346; AP (95%CI):1.054-1.782; S (95%CI):0.160-0.765), and PHQ-9 score and SF-36 score (RERI (95%CI): 0.076-0.421; AP (95%CI): 1.022-1.821; S (95%CI): 0.165-0.873). Conclusion: The family functioning of DR-TB patients was at a general level, and was affected by many factors, and there were interactions among all factors. It is necessary to formulate and implement corresponding intervention measures according to these influencing factors, to effectively improve their family functioning, and further improve disease treatment effectiveness.

Key words: Tuberculosis, pulmonary, Drug resistance, Antitubercular agents, Family relations, Factor analysis, statistical