Factors related to self-care in Korean patients with tuberculosis: A systematic review and meta-analysis

Tuberculosis (TB) remains a major public health challenge in South Korea which has one of the highest TB incidence rates among the Organisation for Economic Co-operation and Development (OECD) countries. Effective self-care, including medication adherence and regular hospital visits, is crucial for successful TB treatment and the prevention of drug resistance. TB self-care in South Korea is influenced by cultural, social, and systemic factors. This study aimed to systematically review and conduct a meta-analysis of factors influencing self-care among Korean patients with TB, providing evidence-based insights for developing effective self-care promotion programs.

A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, focusing on quantitative studies published since 2000 involving Korean patients with TB. Twenty studies were included in the final analysis, and 44 factors related to self-care were categorized into sociodemographic, TB-related, psychological, environmental, and educational characteristics. Effect sizes were calculated using Comprehensive Meta-Analysis (CMA) 4.0, with the assessment of heterogeneity and publication bias.

The meta-analysis ranked the effect sizes of the different characteristic categories as follows: environmental > educational > psychological. Among the individual factors, social support had the greatest influence on self-care, followed by quality of life, self-efficacy, nonfamily support, family support, and perceived health benefits. These findings underscore the critical role of sustained social support from the community, medical staff, and family in enhancing self-care among TB patients.

Effective self-care strategies for patients with TB should focus on interventions that strengthen the environmental, educational, and psychological aspects. These findings suggest that similar approaches can be applied in other countries facing comparable healthcare challenges. This study acknowledges limitations including potential publication bias and the exclusion of older studies and non-Korean patient studies, highlighting the need for further research across diverse settings and populations.