摘要
目的 探讨院外跟踪护理对提高慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者医疗依从性及生活质量的应用价值。方法 选择2016年1月至2017年12月门诊收治的COPD合并PTB患者90例随机分为观察组和对照组,每组45例。在院外康复期间,对照组仅接受常规护理,观察组患者根据奥瑞姆(Orem)理论给予院外跟踪护理管理。分别采用圣·乔治医院呼吸问题调查问卷(SGRQ)评估患者生活质量情况,采用慢性病患者健康素养与医疗依从性调查问卷评估患者对医嘱的依从性,并比较两组患者临床症状显著改善时间和出院后6个月的痰菌转阴率。结果 与出院时比较,对照组患者在出院1个月后和出院6个月后的SGRQ总评分及各维度评分显著升高,且出院6个月后的总评分及各维度评分显著高于出院1个月后,差异均有统计学意义( P <0.05);观察组患者的总评分和各维度评分与出院时比较差异无统计学意义( P > 0.05 ),且在出院1个月后和出院6个月后的评分均显著低于对照组评分,差异均有统计学意义( P <0.05)。在医疗依从性方面,与出院1个月时比较,对照组在出院后6个月时的各项依从性评分显著下降( P <0.05);而观察组患者的各项评分虽略有下降,但差异无统计学意义( P >0.05)。与对照组比较,观察组患者在出院1个月后和6个月后的各项依从性评分明显更高,差异均有统计学意义( P <0.05)。观察组患者的临床症状改善时间显著短于对照组[(26.7±5.6)d vs.(43.5±6.8)d, P <0.05],痰菌转阴率显著高于对照组(87.1% vs. 62.5%, P < 0.05 )。结论 院外跟踪护理干预有助于COPD合并PTB患者提高对医嘱的依从性,提高痰菌转阴率,巩固临床治疗效果,从而提高患者的生活质量,值得推广应用。
Objective To explore the value of extra-hospital follow-up nursing in improving the medical compliance and quality of life of patients with chronic obstructive pulmonary disease (COPD) complicated with pulmonary tuberculosis (PTB). Methods Ninety patients with COPD and PTB who were admitted to the outpatient clinic from January 2016 to December 2017 were randomly divided into observation group and control group,with 45 cases in each group.During out-of-hospital rehabilitation,the control group received only routine care,and the observation group patients were given extra-hospital follow-up care management according to Orem theory.The St.George′s Hospital Respiratory Questionnaire (SGRQ) was used to assess the quality of life of patients,and the patient′s compliance with medical advice was assessed using the Health Literacy and Medical Compliance Questionnaire for Chronic Patients.The time of significant improvement in clinical symptoms and the negative rate of bacillus at six months after discharge between the two groups were compared. Results Compared with the time of discharge,the SGRQ total score and the scores of each dimension of the control group were significantly higher after one month of discharge and six months after discharge,and after six months of discharge,the total score and the scores of each dimension were significantly higher than those after one month of discharge,and the difference was statistically significant ( P <0.05).In terms of medical compliance,compared with one month after discharge,the compliance scores of the control group decreased significantly at 6 months after discharge ( P <0.05).While the scores of the observation group decreased slightly,the difference was not statistically significant ( P >0.05).Compared with the control group,the compliance scores of the observation group were significantly higher after one month and six months after discharge,and the differences were statistically significant ( P <0.05).The clinical symptom improvement time of the observation group was
作者
苏娜
樊安芝
赵毅
SU Na;FAN Anzhi;ZHAO Yi(Second Department of Tuberculosis;Department of General Internal Medicine,Chongqing Public Health Medical Center,Chongqing 400030,China)
出处
《检验医学与临床》
CAS
2019年第12期1699-1702,1705,共5页
Laboratory Medicine and Clinic
关键词
慢性阻塞性肺疾病
肺结核
医疗依从性
生活质量
chronic obstructive pulmonary disease
pulmonary tuberculosis
medical compliance
quality of life
