Effects of the LEARNS model-based self-management education on short-term treatment outcomes among newly diagnosed tuberculosis patients: a randomized controlled trial.

BACKGROUND AND OBJECTIVES: Newly diagnosed patients with pulmonary tuberculosis usually have insufficient self-management ability. LEARNS model-based health education has been shown to significantly improve patients' self-management and treatment outcomes. This randomized controlled trial aimed to evaluate the effects of the LEARNS model-based self-management intervention on six indicators among patients with newly diagnosed tuberculosis: self-management, tuberculosis prevention and control knowledge, anxiety, depression, social support, and treatment efficacy. METHODS: This prospective, two-arm, parallel-group randomized controlled trial was registered (ChiCTR2400090561). Seventy-two inpatients with newly diagnosed pulmonary tuberculosis were enrolled from the tuberculosis department of a tertiary hospital in Ningxia between May and July 2024. Participants were randomly assigned to receive either routine tuberculosis self-management education (control group) or standardized LEARNS model-based self-management education (intervention group). Self-management was defined as the primary outcome. Secondary outcomes encompassed tuberculosis prevention and control knowledge, perceived social support, anxiety, depression, sputum smear and culture conversion rates, and chest CT lesion improvement rates. All participants underwent a 2-month integrated intervention program involving inpatient-based education and continuous post-discharge follow-up. All study outcomes were evaluated 3 months after program completion. All intention-to-treat analyses were performed using generalized estimating equations to evaluate short-term intervention effects. RESULTS: At 3 months following the 2-month integrated intervention program, the intervention group showed significant improvements in self-management (β = 15.51, 95% CI: 5.03-25.99, P = 0.004), tuberculosis prevention and control knowledge (β = 0.87,95%CI: 0.14-1.60, P = 0.019), and chest radiograph improvement rate (χ2 = 7.497, P = 0.024) compared with the control group. No significant between-group differences were observed in perceived social support (β = -1.09, 95% CI: -6.26 to 4.07, P = 0.678), anxiety (β = 0.96, 95% CI: -0.36 to 2.27, P = 0.154), depression (β = 0.13, 95% CI: -1.36 to 1.62, P = 0.864), or sputum smear and culture conversion rates (χ2 = 1.857, P = 0.395). CONCLUSIONS: The LEARNS model-based self-management program benefits inpatients with newly diagnosed pulmonary tuberculosis. It effectively improves patients' self-management and tuberculosis prevention and control knowledge, and improves chest radiographic findings. However, this intervention yields no significant effects on anxiety, depression, social support, and sputum bacteriological conversion.