家庭医生护理服务模式在初治痰菌阳性肺结核患者中的应用效果
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摘要
目的探讨家庭医生护理服务模式在初治痰菌阳性肺结核患者中的应用效果。方法选取2016年5月～2017年7月我所收治的60例初治痰菌阳性肺结核患者,按照随机数字表法分为对照组和实验组,每组各30例。对照组按抗结核方案治疗,实验组实施家庭医生护理服务模式辅助抗结核方案治疗,比较1年内两组治疗的依从性、1年后患者的焦虑和抑郁评分、不同时间痰菌转阴率。结果干预期间实验组的正确用药率和日常自我管理水平评分高于对照组,差异有统计学意义(P<0.05);实验组的焦虑和抑郁评分均明显低于对照组(P<0.05);实验组干预1、2个月后的痰菌转阴率均显著高于对照组,差异有统计学意义(P<0.05),两组干预3个月后的痰菌转阴率比较,差异无统计学意义(P>0.05)。结论初治痰菌阳性肺结核患者实施家庭医生护理服务模式能有效缓解患者的焦虑抑郁情况,患者的治疗依从性较好且痰菌转阴较快。
Objective To explore the application effect of family doctor care service mode in patients with newly diagnosed sputum positive tuberculosis. Methods Sixty patients with newly diagnosed sputum-positive pulmonary tuberculosis admitted to our institute from May 2016 to July 2017 were enrolled. They were divided into control group and experimental group according to random number table method, 30 cases in each group. The patients in the control group were provided with the anti-tuberculosis regimen. In the experimental group, the family doctor care service mode as an assistance to the anti-tuberculosis regimen was adopted. The treatment compliance within one year, and the anxiety and depression scores after one year, and the negative conversion ratio of sputum in different time were compared in the two groups. Results During the intervention period, the correct medication rate and daily self-management scores of the experimental group were higher than those of the control group with statistical differences(P<0.05). The anxiety and depression scores of the experimental group were significantly lower compared with those of the control group(P<0.05).The negative conversion ratio of sputum after one-and-two-month intervention in the experimental group was significantly higher than that of the control group with statistical significance(P<0.05). The negative conversion ratio of sputum was not displayed statistical difference after 3-month intervention in the two groups(P>0.05). Conclusion The implementation of the family doctor care service model for patients with newly diagnosed sputum positive tuberculosis can effectively alleviate patients′ anxiety and depression in a good treatment compliance and a quick negative conversion ratio of sputum.
Objective To explore the application effect of family doctor care service mode in patients with newly diagnosed sputum positive tuberculosis. Methods Sixty patients with newly diagnosed sputum-positive pulmonary tuberculosis admitted to our institute from May 2016 to July 2017 were enrolled. They were divided into control group and experimental group according to random number table method, 30 cases in each group. The patients in the control group were provided with the anti-tuberculosis regimen. In the experimental group, the family doctor care service mode as an assistance to the anti-tuberculosis regimen was adopted. The treatment compliance within one year, and the anxiety and depression scores after one year, and the negative conversion ratio of sputum in different time were compared in the two groups. Results During the intervention period, the correct medication rate and daily self-management scores of the experimental group were higher than those of the control group with statistical differences(P<0.05). The anxiety and depression scores of the experimental group were significantly lower compared with those of the control group(P<0.05).The negative conversion ratio of sputum after one-and-two-month intervention in the experimental group was significantly higher than that of the control group with statistical significance(P<0.05). The negative conversion ratio of sputum was not displayed statistical difference after 3-month intervention in the two groups(P>0.05). Conclusion The implementation of the family doctor care service model for patients with newly diagnosed sputum positive tuberculosis can effectively alleviate patients′ anxiety and depression in a good treatment compliance and a quick negative conversion ratio of sputum.
引文
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[15]杨筱蓉.个性化健康教育对初治涂阳流动人口肺结核病人痰菌转阴及医疗费用的影响[J].护理研究,2013,27(10):3374-3376.
[2]李亮,许绍发.中国结核病诊疗现状及展望[J].中国实用内科杂志,2015,35(8):643-646.
[3]黄建英,钟球,周琳,等.中国肺结核治疗失败影响因素的Meta分析[J].中华疾病控制杂志,2014,18(2):102-107.
[4]李文文,冯喜英,关巍.结核病诊断与治疗的研究进展[J].中华肺部疾病杂志(电子版),2016,9(2):204-206.
[5]包燕萍,姚全妹.达标互动理论对提高初治痰菌阳性肺结核病人满意度的效果[J].全科护理,2015,13(15):1414-1415.
[6]孙林岚,丁永军.全程督导管理对肺结核患者的临床效果研究[J].医院管理论坛,2015,32(5):27-29.
[7]黄中成,陈建标,孔繁熙.家庭医生服务模式对社区慢性病患者的健康管理效果分析[J].海南医学,2015,26(21):3253-3255.
[8]陈翔.家庭医生制服务模式实施前后家庭病床服务情况的比较研究[J].中国全科医学,2016,19(4):466-469.
[9]刘秀梅,葛彩英,贾鸿雁,等.社区脑卒中患者“家庭医生式”服务模式的探索与实践[J].中华全科医学,2015,13(6):981-983.
[10]李桂玲,韵霞,张春燕,等.家庭医生护理服务模式在初治痰菌阳性肺结核出院病人中的应用[J].护理研究,2017,31(34):4402-4404.
[11]王鲜茹.优质护理干预对肺结核患者用药依从性的影响[J].中国当代医药,2016,23(4):163-165.
[12]李爱玲.优质护理干预对肺结核患者治疗效果及护理质量的影响[J].中国现代药物应用,2016,10(9):242-243.
[13]邹喜荣,尹凤鸣.协同护理模式对初治肺结核患者自我护理能力与治疗依从性的影响[J].中华现代护理杂志,2014,49(1):59-62.
[14]宋如梅,张燕娟,洪树芹.护士-家庭联合督导模式对中青年肺结核患者遵医行为及治疗效果的影响[J].医学临床研究,2017,34(12):2486-2488.
[15]杨筱蓉.个性化健康教育对初治涂阳流动人口肺结核病人痰菌转阴及医疗费用的影响[J].护理研究,2013,27(10):3374-3376.