自我管理在肺结核病人中的应用效果分析
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摘要
目的通过自我管理在肺结核病人中的应用,明确病人参与疾病治疗的管理效果,为建立肺结核病人自我管理模式提供参考和依据。方法按照入院顺序编号,将太原市第四人民医院在2016年8月—2017年9月期间入院的继发性肺结核患者300例,随机分为对照组和观察组,两组患者各150例。对照组实施结核内科一般管理,观察组以自我管理计划为依据,进行自我管理。两组患者的治疗效果,通过病灶好转率、痰菌转阴率和强化治疗率三个康复效果指标进行评价。以成年人健康自我管理能力测评表(AHSMSRS)对患者自我管理能力进行测评。计量资料采用t检验,计数资料采用χ~2检验。结果观察组150例初治肺结核患者的成年人健康自我管理能力总体得分为(129.65±21.82)分,各分量表按照得分指标由高到低的顺序依次为自我管理行为(49.01±6.70)分、自我管理认知(47.15±6.32)分和自我管理环境(33.49±4.58)分,均高于对照组,差异有统计学意义(P<0.01);观察组患者病灶好转率为97.33%,痰菌转阴率为96.67%,强化治疗率为96.00%,均高于对照组,差异有统计学意义(P<0.01)。结论自我管理是一种科学有效的管理方法,结合临床实际应用于肺结核患者,可以提高治疗效果。
Objective Through the application of self-management in pulmonary tuberculosis patients,to clarify the management effect of patients participating in disease treatment,and provide the reference and basis for establishing the self-management mode of pulmonary tuberculosis patients.Methods According to the order of admission,300 patients with secondary pulmonary tuberculosis admitted to Taiyuan Fourth People's Hospital from August 2016 to September 2017 were randomly divided into control group and observation group,150 patients in each group.The control group carried out general management of tuberculosis medicine,while the observation group carried out self-management based on self-management plan.The curative effect of the two groups were evaluated by three indexes:the improvement rate of focus,the negative rate of sputum bacteria and the intensive treatment rate.Adult health self-management ability scale(AHSMSRS) was used to evaluate patients' self-management ability.Measuring data were tested by t test and counting data by χ~2 test.Results The total score of health self-management ability of 150 newly treated pulmonary tuberculosis patients in the observation group was(129.65 +21.82).The order of each subscale were self-management behavior(49.01±6.70),self-management cognition(47.15±6.32) and self-management environment(33.49±4.58) according to the score index from high to low.The total score of the scale,self-management behavior,self-management cognition and self-management environment in the observation group were higher than those in the control group,with statistical significance(P<0.01).The improvement rate of focus,sputum negative conversion rate and intensive treatment rate in the observation group were 97.33%,96.67% and 96.00% respectively,which were higher than those in the control group(P<0.01).Conclusion Self-management is a scientific and effective management method,combined with clinical application in patients with pulmonary tuberculosis,it can improve the treatment effect.
Objective Through the application of self-management in pulmonary tuberculosis patients,to clarify the management effect of patients participating in disease treatment,and provide the reference and basis for establishing the self-management mode of pulmonary tuberculosis patients.Methods According to the order of admission,300 patients with secondary pulmonary tuberculosis admitted to Taiyuan Fourth People's Hospital from August 2016 to September 2017 were randomly divided into control group and observation group,150 patients in each group.The control group carried out general management of tuberculosis medicine,while the observation group carried out self-management based on self-management plan.The curative effect of the two groups were evaluated by three indexes:the improvement rate of focus,the negative rate of sputum bacteria and the intensive treatment rate.Adult health self-management ability scale(AHSMSRS) was used to evaluate patients' self-management ability.Measuring data were tested by t test and counting data by χ~2 test.Results The total score of health self-management ability of 150 newly treated pulmonary tuberculosis patients in the observation group was(129.65 +21.82).The order of each subscale were self-management behavior(49.01±6.70),self-management cognition(47.15±6.32) and self-management environment(33.49±4.58) according to the score index from high to low.The total score of the scale,self-management behavior,self-management cognition and self-management environment in the observation group were higher than those in the control group,with statistical significance(P<0.01).The improvement rate of focus,sputum negative conversion rate and intensive treatment rate in the observation group were 97.33%,96.67% and 96.00% respectively,which were higher than those in the control group(P<0.01).Conclusion Self-management is a scientific and effective management method,combined with clinical application in patients with pulmonary tuberculosis,it can improve the treatment effect.
引文
[1] 熊凤鸣,韩爱华,夏淑钧,等.结核病患者服药依从性与自我管理行为生活方式的相关性及其护理对策[J].河北医学,2013,19(4):591-594.
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[9] 徐琦,温文沛,梁国添,等.肺结核患者健康行为量表初步编制及应用[J].实用医学杂志,2010,26(15):2755-2758.
[10] 孟伟,辛焰.结核病患者实施自我管理模式的效果分析[J].医药管理,2014,11(2):187-188.
[11] 范滟,余小萍.老年慢性病患者自我管理与干预的研究进展[J].上海护理,2012,12(6):73-75.
[12] 谈迪心,王斌,李绪辉,等.老年结核病患者自我健康管理评定量表的信效度研究[J].中国全科医学,2017,20(34):4299-4303.
[13] 郦桂青,谭守勇,高翠南,等.肺结核患者自我效能及其影响因素分析[J].中国防痨杂志,2012,34(8):519-522.
[14] 邹喜荣,尹凤鸣.回访式自我管理教育对肺结核病人服药依从性的影响[J].护理实践与研究,2013,10(13):9-11.
[15] 赵一菊,王声湧.科学推进结核病防控策略实现“十三五”结核病防治规划[J].中华疾病控制杂志,2017,21(5):431-433,538.
[2] 齐力,董文兰,毛凡,等.自我管理小组活动对糖尿病患者自我效能影响因素分析[J].中国公共卫生,2016,32(5):628-631.
[3] 王玉霞,杨桂霞,刘淑娟,等.肺结核合并糖尿病患者的自我护理管理分析[J].中国伤残医学,2012,20(6):124-125.
[4] 彭超,包玉香.病人参与型护理模式在肺结核合并糖尿病患者自我管理中的应用[J].泰山医学院学报,2016,37(8):953-954.
[5] 庄荣珍,梁志全,何燕,等.肺结核合并2型糖尿病患者全程自我管理干预的效果[J].沈阳医学院学报,2015,17(1):22-24.
[6] 赵秋利,黄菲菲.成年人健康自我管理能力测评量表的编制及信度和效度检验[J].中华现代护理杂志,2011,17(8):869-872.
[7] 马淑焕,陈爱民.52例艾滋病合并结核病患者自我护理行为干预的效果分析[J].中国防痨杂志,2015,37(8):901-903.
[8] 徐秋红,王红燕.自我管理教育对门诊肺结核患者自护能力的影响[J].解放军护理杂志,2015,32(3):74-76.
[9] 徐琦,温文沛,梁国添,等.肺结核患者健康行为量表初步编制及应用[J].实用医学杂志,2010,26(15):2755-2758.
[10] 孟伟,辛焰.结核病患者实施自我管理模式的效果分析[J].医药管理,2014,11(2):187-188.
[11] 范滟,余小萍.老年慢性病患者自我管理与干预的研究进展[J].上海护理,2012,12(6):73-75.
[12] 谈迪心,王斌,李绪辉,等.老年结核病患者自我健康管理评定量表的信效度研究[J].中国全科医学,2017,20(34):4299-4303.
[13] 郦桂青,谭守勇,高翠南,等.肺结核患者自我效能及其影响因素分析[J].中国防痨杂志,2012,34(8):519-522.
[14] 邹喜荣,尹凤鸣.回访式自我管理教育对肺结核病人服药依从性的影响[J].护理实践与研究,2013,10(13):9-11.
[15] 赵一菊,王声湧.科学推进结核病防控策略实现“十三五”结核病防治规划[J].中华疾病控制杂志,2017,21(5):431-433,538.