Role of Treatment Adherence, Doctor–Patient Trust, and Communication in Predicting Treatment Effects Among Tuberculosis Patients: Difference Between Urban and Rural Areas

Figures & data

Figure 1 The research model based on the hypotheses.

Abbreviations: DPT, doctor–patient trust; DPC, doctor–patient communication.

Table 1 Demographic and Social Characteristics of the Sample

Variables	Description	Number	Percentage (%)
Gender	Male	374	66.31
	Female	190	33.69
Age (years)	<21	26	4.61
	21–40	196	34.75
	41–60	181	32.09
	>60	161	28.55
Marriage	Married	401	71.10
	Unmarried/Widowed	163	28.90
Immigration	Yes	93	16.49
	No	471	83.51
Residence	Urban	267	47.34
	Rural	297	52.66
Education	Primary or below	123	21.28
	Middle school	193	34.22
	High school	120	21.28
	College or above	128	22.70
Income (yuan/month)	<1000	223	39.54
	1000~3000	129	22.87
	3000~5000	151	26.77
	>5000	61	10.82

Table 2 Description of Constructs and Differences Between Urban and Rural Areas

Constructs	Total	Urban	Rural	P-value for t-test
DPT	3.31±0.76	3.22±0.85	3.39±0.66	0.007
DPC	3.30±0.71	3.40±0.73	3.21±0.68	0.001
Adherence	3.72±0.66	3.72±0.69	3.71±0.64	0.845
TE	3.63±0.71	3.70±0.66	3.58±0.75	0.027

Note: Numbers listed here are mean and standard deviation.

Abbreviations: DPT, doctor–patient trust; DPC, doctor–patient communication; TE, treatment effect.

Table 3 Results of the Reliability and Validity Test

Construct	Items	F.L. Range	CR	Convergence Validity (AVE)	Discriminant Validity
					DPT	DPC	Adherence	TE
DPT	4	0.785~0.818	0.879	0.645	0.803
DPC	4	0.675~0.831	0.852	0.592	0.547	0.769
Adherence	2	0.881~0.894	0.881	0.788	0.050	0.171	0.887
TE	3	0.616~0.699	0.691	0.428	0.145	0.164	0.324	0.654

Notes: The bold diagonal value is , and the lower triangular number is the Pearson correlation coefficient between constructs.

Abbreviations: F.L., factor loading; CR, composite reliability; AVE, average of variance extracted; DPT, doctor–patient trust; DPC, doctor–patient communication; TE, treatment effect.

Table 4 Fitting Index of the Research Model

Index	Criteria	Model 1 (Total)	Model 2 (Grouping)	Support or Not
Chi-square	Small is better	148.545	255.163	Support
DF	Larger is better	59	136	Support
Chi-square/DF	3>Chi-square/DF>1	2.518	1.876	Support
CFI	>0.90	0.972	0.953	Support
TLI	>0.90	0.963	0.946	Support
RMSEA(90% CI)	<0.08	0.052(0.042, 0.062)	0.056(0.045, 0.066)	Support
SRMR	<0.08	0.039	0.061	Support

Abbreviations: DF, degree of the freedom; CFI, comparative fit index; TLI, Tucker-Lewis index; RMSEA, root mean squared error of approximation; SRMR, standardized root mean square residual; CI, confidence interval. Model 1 did not separate between urban and rural areas, but Model 2 did.

Table 5 Determinants and Mechanism of Treatment Effect Among TB Patients in China

Description	Estimate(b)	S.E.	Est./S.E.	P-value	Bootstrap 95% CI (Bias Uncorrected)			Bootstrap 95% CI (Bias Corrected)
					Lower	Upper		Lower	Upper
DPT→TE	0.113	0.079	1.441	0.150	−0.041	0.263		−0.028	0.272
DPC→TE	0.070	0.090	0.780	0.435	−0.103	0.242		−0.114	0.238
Adherence→TE	0.353	0.076	4.650	<0.001	0.188	0.482		0.199	0.488
DPT→Adherence	−0.062	0.074	−0.845	0.398	−0.184	0.103		−0.183	0.108
DPC→Adherence	0.214	0.071	3.031	0.002	0.066	0.343		0.081	0.360
DPT→Adherence→TE	−0.022	0.026	−0.849	0.396	−0.072	0.032		−0.072	0.032
DPC→Adherence→TE	0.076	0.031	2.452	0.014	0.018	0.136		0.026	0.152

Abbreviations: DPT, doctor–patient trust; DPC, doctor–patient communication; TE, treatment effect; CI, confidence interval; bootstrap times=2000; S.E., standard error; Est, estimate.

Table 6 Difference in Treatment Between Urban and Rural Patients

Description	Urban			Rural			Difference
	Estimate	95% CI		Estimate	95% CI		Estimate	95% CI
DPT→TE	−0.010	(−0.169, 0.164)		0.382*	(0.068, 0.696)		0.391*	(0.024, 0.742)
DPC→TE	0.140	(−0.072, 0.385)		−0.111	(−0.378, 0.162)		−0.251	(−0.629, 0.097)
Adherence→TE	0.286**	(0.072, 0.444)		0.464***	(0.197, 0.693)		0.178	(−0.125, 0.494)
DPT→Adherence	0.028	(−0.108, 0.206)		−0.222	(−0.398, 0.007)		−0.250*	(−0.471, −0.010)
DPC→Adherence	0.090	(−0.107, 0.258)		0.376***	(0.159, 0.540)		0.287*	(0.036, 0.542)
DPT→Adherence→TE	0.008	(−0.036, 0.056)		−0.103	(−0.212, 0.004)		−0.111*	(−0.227, −0.002)
DPC→Adherence→TE	0.026	(−0.029, 0.084)		0.175**	(0.044, 0.294)		0.149*	(0.015, 0.282)

Notes: *P<0.05, **P<0.01, ***P<0.001.

Abbreviations: DPT, doctor–patient trust; DPC, doctor–patient communication; TE, treatment effect; CI, confidence interval; bootstrap times=2000.