医院-社区-家庭三元联动对肺结核患者用药依从性及生活质量影响

Evaluation of the effect of hospital-community-family linkage on drug compliance and quality of pulmonary tuberculosis patients

目的为了增强医院-社区的协作性和协调性,避免医院过度家庭的护理脱节,本研究探讨应用医院-社区-家庭三元联动模式对肺结核患者用药依从性和生活质量的影响,为肺结核患者提供科学的照护。方法选择2018-09-01-2019-02-28德阳市人民医院收治的156例肺结核患者为研究对象,按照性别、年龄、病程和组间均衡的原则分为2组,每组78例。对照组接受常规健康教育、出院指导、电话随访和门诊复诊。观察组在对照组的基础上应用医院-社区-家庭三元联动模式进行全程规范化用药指导和监督。分别于出院后1个月观察两组患者用药依从性和生活质量,疾病知识知晓率及满意度。采用生命质量评价量表(short form 36 questionnaire,SF-36)、Morisky用药依从性问卷(morisky medication adherence scale,MMAS-8)、肺结核疾病知识问卷及患者满意度问卷进行测评分析。结果观察组患者出院1个月后,用药依从性良好71例,依从率91.03%,服药依从性高于对照组(45例,57.69%),差异有统计学意义,χ~2=11.86,P<0.001。观察组生理机能得分(89.21±9.56)分,生理职能得分(78.95±20.84)分,躯体疼痛得分(86.86±10.04)分,一般健康状况得分(69.47±8.00)分,精力得分(82.57±12.07)分,社会功能得分(89.60±10.94)分,情感职能得分(75.45±25.17)分,精神健康得分(68.74±14.61)分,均高于对照组,差异有统计学意义,均P<0.05。患者疾病知识知晓率观察组为97.44%,对照组61.54%,观察组高于对照组,差异有统计学意义,χ~2=15.52,P<0.001;患者满意度观察组为96.15%,对照组为83.33%,观察组高于对照组,差异有统计学意义,χ~2=7.82,P<0.001。结论医院-社区-家庭三元联动模式能够提高肺结核患者用药依从性,改善患者生活质量,提高患者满意度。

OBJECTIVE To explore the effect of hospital-community-family linkage model on drug compliance and quality of life of pulmonary tuberculosis patients.Strengthen hospital-community collaboration and coordination,avoid excessive family care disconnection in hospitals,and provide scientific care for tuberculosis patients.METHODS A total of 156 cases of pulmonary tuberculosis admitted to Deyang People’s Hospital form September 1,2018 to February 28,2019 were selected as research objects.They were divided into two groups according to the principle of gender,age,course of disease and balance between groups,with 78 cases in each group.The control group received routine health education,discharge instruction,telephone follow-up and outpatient follow-up.On the basis of the control group,the three-way linkage model of hospital,community and family was applied in the observation group to guide and supervise the whole process of standardized medication.Drug compliance,quality of life,disease knowledge and satisfaction were observed 1 month after discharge.Quality of life evaluation scale(short form 36 Questionnaire,SF-36),Morisky medication compliance questionnaire(Morisky Medication Adherence Scale,MMAS-8),tuberculosis disease knowledge questionnaire and patient satisfaction questionnaire were used to evaluate and analyze.RESULTS One month after discharge,71 patients in the observation group showed good compliance with medication,with a compliance rate of 91.03%,which was higher than that of the control group.Life quality scores of the observation group were:physiological function(89.21±9.56),physiological function(78.95±20.84),physical pain(86.86±10.04),general health(69.47±8.00),energy(82.57±12.07),social function(89.60±10.94),emotional function(75.45±25.17),mental health(68.74±14.61),all of which were higher than those of the control group.The disease knowledge rate of patients in the observation group was 97.44%,61.54%in the control group,and 35.90%in the observation group.Patients’satisfaction was 96.15%in the observation group,83.33%in the control group,and 12.82%in the observation group,with statistically significant differences(P<0.05).CONCLUSION The three-way linkage model of hospital-community-family can improve the drug compliance of tuberculosis patients,improve the quality of life of patients,improve patient satisfaction and disease knowledge,promote the effective management of chronic diseases,promote the healing of diseases,and achieve satisfactory clinical application.