摘要
目的评价提高肺结核患者治疗依从性干预措施的效果。方法随机抽取846例肺结核患者,随机分为干预组和对照组。所有患者按照标准治疗方案治疗满2个月时,对照组依然采取常规督导管理方式,对干预组除采取常规督导管理方式外增加干预措施。收集患者5个月末和6个月末(复治患者8个月末)复查、取药延迟情况进行分析。结果 846例患者中,54例中途因死亡、拒绝访视等原因退组外,792例患者观察了5个月末和6(8)个月末复查、取药情况。对照组和干预组基本情况无显著性差异(P>0.05)。对照组与干预组5个月末和6(8)个月末依从性差异有统计学意义(P<0.05),干预组依从性显著高于对照组。多元Logistic回归分析结果表明,5个月末诊断结果情况(OR=1.51,P<0.05),表明涂阳患者复查依从性较涂阴患者好;是否干预(OR=1.83,P<0.05),表明有干预患者依从性较无干预的好。6(8)个月末不同民族情况(OR=1.63,P<0.05),表明汉族复查依从性较少数民族好;诊断结果情况(OR=1.59,P<0.05),表明涂阳患者复查依从性较涂阴患者好;是否干预(OR=2.03,P<0.05),表明有干预患者依从性较无干预的好。两组患者5个月末和6(8)个月末均存在延迟现象,对照组与干预组5个月末和6(8)个月末平均延迟天数差异有统计学意义(P<0.05),表明干预组延迟天数显著低于对照组。结论结合贵州省情制定的干预措施能显著提高患者治疗依从性和缩短患者延迟复查时间,且不需要大量经费投入,适合在贵州省推广。
Objective To determine the effect of intervention measures to improve treatment compliance in the patients with tuberculosis. Methods Eight hundreds and forty-six patients with tuberculosis were subjected by cluster random sampling from the patients who registered in 88 Disease Control and Prevention Centers in Guizhou Province from November 4, 2013 to May 3, 2014. They were randomly divided into the intervention group and control group. After 2 months of standard treatment, the patients in the control group were treated with routine supervision management, and those in the intervention group were treated with supervision management and intervention measures. The review and medicine delay conditions of patients in the late of May and June （August for retreatment） were analyzed. Results Of the 846 patients, besides 54 cases who quitted from the study because of death or refusal, 792 cases were observed for the review and medicine in late May and June （August）. There was no significant difference between the basic condition of the control group and intervention group （P 〉 0.05 ）. The treatment compliance was significantly higher in the intervention group than the control group （ P 〈 0.05 ）. Multivariate logistic regression analysis showed that the diagnosis results of the late May indicated that the compliance of smear-positive patients were better than those negative （ OR = 1.51, P 〈 O. 05 ）, and were better in the intervention patients than those without （ OR = 1.83, P 〈 0.05 ）, and the results of the late August, the compliance better in Han nationality than minority nationalities （ OR = 1.63, P 〈 0.05 ）, and similar results were seem in the smear-positive patients and negative ones （ OR = 1.59, P 〈 0. 05 ）, and those receiving intervention or not （ OR = 2.03, P 〈 0.05 ）. There were delays in the patients in both groups, and the average delay days was significant lower in the intervention group than the control （P 〈0.05）. Conclusion Intervention based on th
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2015年第23期2382-2385,共4页
Journal of Third Military Medical University
基金
贵州省卫生计生委科研基金(gzwkj2013-1-080)~~
关键词
结核
预防和控制
依从性
干预
tuberculosis
prevention and control
compliance
intervention
