循证护理在社区流动人口结核病人用药问题的应用

EVIDENCE-BASED NURSING IN THE COMMUNITY OF THE FLOATING POPULATION OF TB DRUG PROBLEM

目的探讨循证护理在社区流动人口结核病人用药问题中的应用,以提高病人的服药依从性。方法根据流动人口结核病患者的特点、服用抗结核药物应具备的知识,提出问题,检索中国医院数字图书馆、万方医学网及中国知网等数据库和手工检索有关医学期刊、专著,查找高质量的护理证据,并根据病人实际情况及循证证据制定针对性的护理干预措施。结果纳入相关文献资料证据表明:①大多数流动人口坚持治疗决心相对较差,与其对疾病的认知水平低,对知识的接受能力差,经济收入低下及无医疗保障有关;②肺结核治愈的关键是全程、规律服药,患者能否坚持规律用药,与其对肺结核病知识的了解程度有密切关系;③常用抗痨药物大都有不同程度的不良反应,药物副反应高是患者未能坚持疗程的主要原因之一;④服药依从性低可导致肺结核治疗的失败,使初治者产生耐药性,从而使初治者变为复治者,甚至不能治愈,成为社会的传染源[1]。综合文献信息并结合患者具体情况,全疗程实施有针对性的用药指导,循环互动式健康教育,患者遵医嘱按时复查、主动配合治疗等方面循证护理组均显著优于常规组。结论将循证护理应用到流动人口结核病人的用药指导中,可提高病人对抗痨药物的认知水平及药物不良反应的应对能力,更好地完成整个治疗疗程,从而提高流动人口结核病人的遵医行为。

Objective The purpose of the article is to examine the applicability of the EBN method on tuberculosis patients＇ medication issue in a migrant populated community in order to enhance patients＇ obedience towards prescription. Methods The methodology is rising questions based on the traits of the floating population and the hasic knowledge of taking anti - tuberculous drugs, researching high quality data on databases such as China Hospital Digital Library,Wanfang medicine and Chinese HowNet, periodicals, and monographs. Results Evidences from relat- ed literature show：l. Most of the migrants relatively lack of determination on continuing medication due to the poor knowledge toward tuberculous, poor understanding ability towards such knowledge, and poor financial income, and of medicare program. 2. The key of treating lung tuberculous is finishing the entire medication in a regular basis. Study shows that knowledge towards the disease play a key role on patients＇ will on taking medication regularly. 3. Most of the common anti - tuberculous drugs have different level of side effects. Serious side effects is one of the main reasons of irregularly medication. 4. Irregular medication will lead to failure on lung tuberculous treatment. Patients who suffer drug tolerance repeatedly may become cureless, and a source of infection in the society. Through integrating the liter- ature information and patients＇ situation, we found that by using EBN method, specializing medication guidance and interactive health education, patients do better in following doctor＇s advice, counterchecking, and coordinating with the medication. Conclusion In conclusion, using EBN method for special medication guidance for patients in a floating populated context increase patients＇ knowledge on anti - tuberculous medication which make the medication easier to be followed. In this case, migrant patients have a better ability to follow doctor＇s advise and prescription.