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Copyright © 2015 Korean Society of Adult Nursing
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Item Analysis and Inter-Item Correlation and Reliability for Initial 67 Items (N=191)
| Item contents | M±SD | Corrected item-total correlation | Cronbach's ⍺ if item is deleted |
|---|---|---|---|
| 1. I have financial difficulties due to job loss after the onset of TB. | 3.13±0.97 | .20 | .97 |
| 2. I feel weak in whole body after the onset of TB. | 3.08±0.83 | .41 | .97 |
| 3. I am easily tired after the onset of TB. | 3.15±0.82 | .40 | .97 |
| 4. I lost much weight after the onset of TB. | 3.08±1.03 | .22 | .97 |
| 5. I am socially withdrawn due to TB. | 3.12±0.87 | .50 | .97 |
| 6. I am unemployed due to TB despite attempts to be employed. | 3.06±0.92 | .51 | .97 |
| 7. People distance me since the onset of TB. | 2.78±1.04 | .63 | .97 |
| 8. I lost social position and self esteem after the onset of TB. | 2.94±0.93 | .61 | .97 |
| 9. I feel anxious and lonely due to TB. | 2.94±0.97 | .61 | .97 |
| 10. I cannot be close to my family due to fear of contamination. | 3.12±0.89 | .60 | .97 |
| 11. I worry if my family has been contaminated due to my cough. | 3.16±0.88 | .45 | .97 |
| 12. My family distances me since the onset of TB. | 2.27±1.15 | .60 | .97 |
| 13. I cannot openly interact with friends since the onset of TB. | 2.86±1.02 | .61 | .97 |
| 14. I am very anxious I cannot have a normal social life compared to my friends since the onset of TB. | 2.96±0.96 | .54 | .97 |
| 15. My friends avoid me since the onset of TB. | 2.55±1.11 | .61 | .97 |
| 16. I don't want to show anyone my lung photos. | 2.91±1.03 | .44 | .97 |
| 17. I think TB is an embarrassing disease. | 3.04±0.96 | .49 | .97 |
| 18. I am afraid I will be known as a TB patient. | 3.08±0.92 | .56 | .97 |
| 19. I don't want to tell people I was hospitalized for TB. | 2.98±0.85 | .40 | .97 |
| 20. I take my TB medication in secret. | 2.63±1.02 | .62 | .97 |
| 21. My life has become a mess since I became a TB patient. | 2.76±0.97 | .47 | .97 |
| 22. I feel shameful because I cannot function as a person since the onset of TB. | 2.86±0.94 | .64 | .97 |
| 23. I feel I lost my value since the onset of TB. | 2.87±0.99 | .66 | .97 |
| 24. I feel helpless/powerless due to the reality of TB. | 2.97±0.91 | .61 | .97 |
| 25. I feel others reject me if/when I wear a mask. | 2.82±0.96 | .56 | .97 |
| 26. I feel I have become a weak person since I became a TB care patient. | 2.76±0.96 | .56 | .97 |
| 27. I don't want to accept I have a contagious disease. | 2.66±1.00 | .58 | .97 |
| 28. I feel less desperate for medication since my symptoms improved. | 2.44±1.02 | .57 | .97 |
| 29. My will to take medication is progressively decreasing. | 2.21±1.10 | .68 | .97 |
| 30. I thought about stopping treatment after my symptoms improved. | 2.15±1.04 | .59 | .97 |
| 31. I often forget the seriousness of TB. | 2.24±1.00 | .48 | .97 |
| 32. I have tried alternative medicine because I did not know the importance of medication. | 2.02±1.05 | .59 | .97 |
| 33. I feel a rush of stress and pressure when I see large amounts of drugs. | 2.90±0.88 | .50 | .97 |
| 34. It is difficult to take medication on time due to irregular meals. | 2.65±1.03 | .50 | .97 |
| 35. I don't want to take medication because meals are no longer enjoyable since the onset of TB. | 2.81±0.97 | .57 | .97 |
| 36. Sometimes, I don't want to take medication due to repulsion against forced treatment. | 2.44±1.08 | .54 | .97 |
| 37. I cannot take medication on time due to the presence of others/other people. | 2.18±1.10 | .68 | .97 |
| 38. I fear taking medication due to severe drug side effects. | 2.59±0.91 | .66 | .97 |
| 39. My whole body aches when I take medication. | 2.56±0.90 | .65 | .97 |
| 40. TB medication is so strong it makes my stomach ache. | 2.71±0.97 | .53 | .97 |
| 41. I am distressed by severe nausea and vomiting. | 2.70±1.06 | .60 | .97 |
| 42. I get acid reflux and my breath smells bitter. | 2.63±0.98 | .51 | .97 |
| 43. I am tired of taking so much medication at once. | 2.93±0.93 | .46 | .97 |
| 44. Remembering to take medication on my own is difficult. | 2.86±1.00 | .46 | .97 |
| 45. I cannot regularly care for TB treatment. | 2.62±1.00 | .42 | .97 |
| 46. I cannot regularly take medication due to my irregular lifestyle. | 2.65±1.02 | .41 | .97 |
| 47. I often cannot make hospital visits due to irregular working hours. | 2.45±1.09 | .46 | .97 |
| 48. I delayed treatment due to difficulty in selecting a follow up hospital. | 2.25±1.03 | .54 | .97 |
| 49. I am reluctant to visit the hospital because there are many tests and long waiting hours. | 2.26±1.02 | .51 | .97 |
| 50. It is inconvenient to visit a follow up hospital because it is far. | 2.32±0.94 | .48 | .97 |
| 51. Hospital visits are burdensome because I am busy at/with work. | 2.29±1.02 | .50 | .97 |
| 52. I have quit medication on my own accord due to powerlessness from TB. | 2.48±1.05 | .57 | .97 |
| 53. I forget to take TB medication if/when I drink alcoholic beverages. | 2.65±1.05 | .51 | .97 |
| 54. I often forget to take TB medication on a regular basis. | 2.39±1.03 | .52 | .97 |
| 55. I don't have enough patience with treatment. | 2.63±0.97 | .52 | .97 |
| 56. If I miss a prescription date, I get lazy and not go afterwards. | 2.62±1.02 | .46 | .97 |
| 57. I feel there are no visible improvements even if take medication. | 2.53±0.86 | .58 | .97 |
| 58. I want to give up treatment, because I have lost trust in medical professionals. | 2.01±0.99 | .66 | .97 |
| 59. I get nervous every time I get a test. | 2.39±0.88 | .53 | .97 |
| 60. I feel TB medication is not a good treatment for me due to severe side effects. | 2.14±0.97 | .63 | .97 |
| 61. I am anxious there seems to be no way to cure TB. | 2.43±0.96 | .54 | .97 |
| 62. I feel there is no hope of improvement at my stage. | 2.05±1.00 | .62 | .97 |
| 63. I fear I may die due to/ from TB. | 2.46±1.06 | .54 | .97 |
| 64. I think TB will reoccur even if I am cured. | 2.62±0.93 | .44 | .97 |
| 65. I am depressed only I got a disease. | 2.40±0.96 | .63 | .97 |
| 66. I am anxious I will not be able to finish TB treatment due to medication tolerance. | 2.49±0.96 | .62 | .97 |
| 67. I am hopeless, because I think I will never be cured. | 2.25±0.99 | .68 | .97 |
TB=tuberculosis; Range of Inter-item correlation: .01 ＜r≤ .70.
Factor Analysis of the Scale of the Risk of TB Treatment Discontinuation (N=191)
| Item contents | Factor loading | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | |
| Factor 1: Difficulties of interpersonal relationship | |||||||||||
| 15. My friends avoid me since the onset of TB. | .74 | .05 | .27 | .08 | .24 | .04 | .07 | .22 | -.01 | .08 | -.12 |
| 7. People distance me since the onset of TB. | .73 | .15 | .15 | .17 | .20 | .13 | .01 | .11 | .12 | .07 | -.02 |
| 14. I'm very anxious I cannot have a normal social life compared to my friends. | .70 | .30 | -.05 | .13 | .03 | .03 | .14 | .07 | .05 | .16 | .04 |
| 13. I cannot openly interact with friends since the onset of TB. | .69 | .25 | .07 | .17 | .05 | .22 | .15 | .10 | -.08 | .11 | -.01 |
| 9. I feel anxious and lonely due to TB. | .66 | .31 | .13 | .17 | .05 | .19 | .03 | .13 | .17 | -.18 | .12 |
| 8. I lost social position and self esteem after the onset of TB. | .66 | .32 | .09 | .10 | .08 | .24 | -.11 | .16 | .18 | -.11 | .15 |
| 12. My family distances me because of TB. | .61 | .07 | .34 | .17 | .10 | .20 | .15 | .11 | -.23 | .26 | -.25 |
| 6. I am unemployed due to TB despite attempts to be employed. | .58 | .18 | .03 | .20 | .13 | .16 | -.08 | -.08 | .26 | -.01 | .20 |
| 10. I cannot be close to my family due to fear of contamination. | .56 | .29 | .16 | .06 | .11 | .03 | .28 | .09 | .22 | .04 | .06 |
| Factor 2: Loss of self-competency as a human being | |||||||||||
| 24. I feel powerless due to the reality of TB. | .20 | .75 | .22 | .15 | .01 | .01 | .11 | -.02 | .14 | .14 | .10 |
| 23. I lost my value since the onset of TB. | .30 | .74 | .19 | .10 | .07 | .07 | .16 | .10 | -.02 | .11 | .13 |
| 22. I feel shameful because I cannot function as a person since the onset of TB. | .36 | .70 | .06 | .13 | .05 | .12 | .06 | .10 | .04 | .22 | .05 |
| 25. I feel others reject me if I wear a mask. | .34 | .67 | .21 | -.01 | .03 | .02 | .09 | .13 | .07 | -.12 | .13 |
| 27. I don't want to accept I have a contagious disease. | .07 | .62 | .26 | .14 | .18 | .12 | .07 | .23 | .08 | .01 | -.18 |
| 20. I take my TB medication in secret. | .21 | .60 | .13 | .11 | .18 | .15 | .06 | .44 | -.05 | .08 | -.04 |
| 26. I feel I have become a weak person since I became a TB care patient. | .18 | .59 | .03 | .20 | .07 | .29 | -.05 | .21 | .06 | .07 | .01 |
| 21. My life has become a mess since I became a TB patient. | .18 | .59 | -.13 | .18 | -.04 | .25 | -.12 | .07 | .16 | .31 | .16 |
| Factor 3: Loss of primary importance for therapeutic compliance | |||||||||||
| 31. I often forget the seriousness of TB. | .01 | .02 | .75 | .06 | .10 | .24 | .10 | -.01 | .01 | .08 | .11 |
| 28. I feel less desperate for medication since my symptoms improved. | .05 | .22 | .72 | .20 | .11 | .14 | .06 | .10 | .09 | -.05 | -.06 |
| 30. I thought about stopping treatment after my symptoms improved. | .20 | .02 | .72 | .03 | .22 | .18 | .15 | .10 | .06 | .10 | .15 |
| 29. My will to take medication is decreasing. | .22 | .17 | .70 | .27 | .14 | .18 | .04 | .10 | .03 | .09 | .01 |
| 32. I have tried alternative medicine because I did not know the importance of medication | .16 | .16 | .61 | .14 | .13 | .29 | -.04 | .14 | -.07 | .11 | .07 |
| 36. Sometimes, I don't want to take medication due to repulsion against forced treatment | .06 | .22 | .59 | .15 | .30 | -.01 | .22 | -.13 | -.12 | .12 | .08 |
| 58. I want to give up treatment, because I have lost trust in medical professionals. | .20 | .19 | .57 | .25 | .42 | .12 | .01 | -.02 | -.03 | .04 | .05 |
| Factor 4: Difficulties to overcome side effects from anti-TB medicines | |||||||||||
| 41. I am distressed by severe nausea and vomiting. | .25 | .13 | .24 | .78 | .16 | .02 | .12 | -.01 | .03 | .06 | .03 |
| 40. TB medication is so strong it makes my stomach ache. | .14 | .20 | .16 | .77 | .12 | -.01 | .02 | .02 | .03 | .11 | -.07 |
| 42. I get acid reflux and my breath smells bitter. | .21 | .03 | .12 | .76 | .10 | .06 | .01 | .05 | .09 | .13 | .14 |
| 43. I am tired of taking so much medication at once. | .08 | .11 | .09 | .70 | -.05 | .13 | .26 | .02 | .01 | .13 | .20 |
| 39. My whole body aches when I take medication. | .14 | .32 | .24 | .64 | .18 | .10 | .07 | .24 | .09 | -.09 | -.05 |
| Factor 5: Failure of medication adherence | |||||||||||
| 54. I often forget to take TB medication on a regular basis. | .19 | .05 | .21 | .11 | .81 | .12 | .04 | .16 | .01 | -.05 | .12 |
| 55. I don't have enough patience with treatment. | .09 | .05 | .28 | .14 | .74 | .04 | .20 | .01 | -.01 | .12 | .07 |
| 56. If I miss a prescription date, I get lazy and not go afterwards. | .11 | .10 | .31 | .08 | .68 | .15 | .14 | -.09 | .03 | -.01 | -.14 |
| 53. I forget to take TB medication when I drink alcoholic beverages. | .23 | .07 | .07 | .10 | .63 | .14 | 24 | .20 | -.05 | .03 | .25 |
| Factor 6: Inconvenience of medical center use | |||||||||||
| 49. I am reluctant to visit the hospital because there are many tests and long waiting hours. | .20 | .17 | .18 | .11 | .09 | .78 | .09 | .02 | .09 | -.08 | -.07 |
| 50. It is inconvenient to visit a follow up hospital because it is far. | .21 | .10 | .28 | .01 | -.03 | .70 | .04 | .11 | -.02 | .14 | .06 |
| 48. I delayed treatment due to difficulty in selecting a follow up hospital. | .16 | .21 | .22 | .06 | .18 | .70 | .21 | -.01 | .06 | .07 | -.21 |
| 51. Hospital visits are burdensome because I am busy at/with work. | .15 | .09 | .23 | -.00 | .15 | .68 | .06 | .03 | .06 | .11 | .29 |
| 47. I often cannot make hospital visits due to irregular working hours. | .04 | .08 | .17 | .15 | .36 | .51 | .38 | -.05 | .03 | .01 | -.06 |
| Factor 7: Having difficulties in maintaining self-care for the TB | |||||||||||
| 45. I cannot regularly care for TB treatment. | .08 | .08 | .24 | .14 | .12 | .04 | .80 | .10 | -.02 | -.06 | .09 |
| 46. I cannot regularly take medication due to my irregular lifestyle. | .18 | .08 | .02 | .03 | .24 | .23 | .77 | .03 | .06 | .03 | -.01 |
| 44. Remembering to take medication on my own is difficult. | .04 | .05 | .05 | .46 | .19 | .17 | .59 | .07 | .07 | -.02 | .19 |
| Factor 8: A sense of shame as a TB patient | |||||||||||
| 18. I'm afraid I will be known as a TB patient. | .38 | .23 | .13 | .05 | .07 | .01 | .12 | .71 | .12 | .14 | .13 |
| 17. I think TB is an embarrassing disease. | .38 | .20 | .10 | -.05 | .05 | .05 | .09 | .71 | .01 | .17 | .22 |
| 19. I don't want to tell people I was hospitalized for TB. | .02 | .30 | .01 | .16 | .04 | .05 | .01 | .65 | .05 | -.08 | -.22 |
| Factor 9: Low physical strength to put up with the compliance | |||||||||||
| 3. I am easily tired after the onset of TB. | .12 | .04 | .02 | .12 | .04 | .12 | .01 | .09 | .85 | .17 | .07 |
| 2. I feel weak in whole body after the onset of TB. | .22 | .24 | -.02 | .05 | -.05 | .02 | .07 | .02 | .79 | .17 | -.12 |
| Factor 10: A pessimistic view of the outcome from TB therapy | |||||||||||
| 64. I think TB will reoccur even if I'm cured. | .10 | .17 | .19 | .16 | -.01 | .05 | -.01 | .09 | .25 | .78 | -.03 |
| 63. I fear I may die from TB. | .11 | .28 | .18 | .20 | .12 | .14 | -.03 | .06 | .17 | .67 | .15 |
| Factor 11: Emotional burden to take anti-TB medicines | |||||||||||
| 33. I feel a rush of stress and pressure when I see large amounts of drugs. | .08 | .18 | .30 | .34 | .18 | -.02 | .12 | .04 | .05 | .05 | .57 |
| 34. It is difficult to take medication on time due to irregular meals. | .10 | .26 | .20 | .23 | .26 | .05 | .30 | .02 | -.16 | .10 | .52 |
| Eigen value | 5.41 | 4.89 | 4.55 | 3.82 | 3.18 | 3.18 | 2.46 | 2.17 | 1.89 | 1.73 | 1.43 |
| Explained Variance (%) | 10.8 | 9.8 | 9.1 | 7.7 | 6.4 | 6.4 | 4.9 | 4.3 | 3.8 | 3.5 | 2.9 |
| Accumulative Variance (%) | 10.8 | 20.6 | 29.7 | 37.4 | 43.8 | 50.2 | 55.1 | 59.4 | 63.2 | 66.7 | 69.6 |
TB=tuberculosis.
Correlation between the Risk of TB Treatment Discontinuation and Depression (N=191)
| Variables | Risk of TB treatment discontinuation | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| F1 | F2 | F3 | F4 | F5 | F6 | F7 | F8 | F9 | F10 | F11 | Total | ||
| r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | r (p) | ||
| Risk of treatment discontinuation | F1 | 1 | |||||||||||
| F2 | .65 | 1 | |||||||||||
| (＜.001) | |||||||||||||
| F3 | .47 | .45 | 1 | ||||||||||
| (＜.001) | (＜.001) | ||||||||||||
| F4 | .44 | .44 | .50 | 1 | |||||||||
| (＜.001) | (＜.001) | (＜.001) | |||||||||||
| F5 | .37 | .28 | .56 | .34 | 1 | ||||||||
| (＜.001) | (＜.001) | (＜.001) | (＜.001) | ||||||||||
| F6 | .41 | .38 | .53 | .29 | .48 | 1 | |||||||
| (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | |||||||||
| F7 | .35 | .29 | .41 | .44 | .47 | .39 | 1 | ||||||
| (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | ||||||||
| F8 | .71 | .57 | .26 | .24 | .24 | .25 | .20 | 1 | |||||
| (＜.001) | (＜.001) | (＜.001) | (.001) | (.001) | (.001) | (.005) | |||||||
| F9 | .34 | .35 | .116 | .25 | .06 | .17 | .12 | .26 | 1 | ||||
| (＜.001) | (＜.001) | (.111) | (＜.001) | (.45) | (.016) | (.093) | (＜.001) | ||||||
| F10 | .37 | .46 | .39 | .39 | .21 | .25 | .20 | .28 | .37 | 1 | |||
| (＜.001) | (＜.001) | (＜.001) | (＜.001) | (.004) | (＜.001) | (.006) | (＜.001) | (＜.001) | |||||
| F11 | .32 | .40 | .49 | .49 | .39 | .24 | .42 | .22 | .08 | .32 | 1 | ||
| (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (.001) | (＜.001) | (.002) | (.258) | (＜.001) | ||||
| Total | .81 | .78 | .77 | .68 | .62 | .65 | .58 | .57 | .38 | .54 | .57 | 1 | |
| (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | |||
| Depression | .39 | .41 | .55 | .40 | .30 | .33 | .22 | .24 | .17 | .32 | .36 | .54 | |
| (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (＜.001) | (.003) | (.001) | (.017) | (＜.001) | (＜.001) | (＜.001) | ||
TB=Tuberculosis.
Reliability for the Final 50 Items (N=191
| Variables | Factor | Factor name (number of item) | M±SD | Cronbach's ⍺ | SEM |
|---|---|---|---|---|---|
| The stigma of being a TB patient | F1 | Difficulties of interpersonal relationship | 2.84±0.70 | .87 | .25 |
| F2 | Loss of self-competency as a human being | 2.79±0.74 | .89 | .24 | |
| F8 | A sense of shame to become a TB patient (20 items) | 3.03±0.76 | .78 | .36 | |
| Sub-total | 2.92±0.65 | .93 | .16 | ||
| Loss of patient role for TB treatment | F3 | Loss of primary importance for therapeutic compliance | 2.21±0.79 | .88 | .28 |
| F10 | A pessimistic view of the outcome from TB therapy (9 items) | 2.53±0.89 | .74 | .45 | |
| Sub-total | 2.49±0.69 | .87 | .21 | ||
| An obstacle to complete treatment for the TB | F4 | Difficulties to overcome side effects from anti-TB medicines | 2.71±0.78 | .86 | .29 |
| F6 | Inconvenience of medical center use | 2.31±0.80 | .84 | .32 | |
| F9 | Low physical strength to put up with the compliance (12 items) | 3.12±0.75 | .80 | .34 | |
| Sub-total | 2.70±0.67 | .84 | .19 | ||
| A lack of will to the therapeutic adherence | F5 | Failure of medication adherence | 2.57±0.84 | .84 | .34 |
| F7 | Having difficulties in maintaining self-care for the TB | 2.71±0.84 | .78 | .40 | |
| F11 | Emotional burden to take anti-TB medicines (9 items) | 2.77±0.84 | .70 | .46 | |
| Sub-total | 2.69±0.71 | .85 | .28 | ||
| Total | 50 items | 2.66±0.54 | .95 | .12 |
SEM=standard error of measurement; TB=tuberculosis.
TB=tuberculosis; Range of Inter-item correlation: .01 ＜r≤ .70.
TB=tuberculosis.
TB=Tuberculosis.
SEM=standard error of measurement; TB=tuberculosis.
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