综合干预对原发性骨质疏松治疗依从性及生活质量的影响

Effect of Comprehensive Intervention on the Treatment Compliance and Quality of Life for Patients with Primary Osteoporosis at Special Consultation Clinic

目的：探讨骨质疏松防治综合干预对特需门诊原发性骨质疏松（POP）患者治疗依从性及生活质量的影响。方法：以2010年5月-2013年5月期间四川大学华西医院国际医疗中心收治的112例POP患者为研究对象,分为干预组和对照组,在药物治疗的同时给予不同的护理措施,6个月后比较两组干预前后POP知识掌握程度（OKT评分）、疼痛（VAS评分）、骨密度（BMD）以及生活质量（OQOLS评分）改善情况;随访1年后评价两组治疗依从性以及骨折发生率。结果：经过6个月的干预,干预组OKT评分、VAS评分以及BMD和治疗前比较差异均有统计学意义（P〈0.001）,和对照组比较差异也均有统计学意义（P〈0.001）。干预组OQOLS评分的5个维度以及生活质量总评分和干预前比较差异均有统计学意义（P〈0.001）,和对照组比较差异也均有统计学意义（P〈0.001）,对照组心理维度和社会维度和干预前比较差异不大（P〉0.05）。两组随访1年,干预组完全依存比例明显高于对照组,不依从比例低于对照组（P〈0.001）;干预组病理性骨折发生率低于对照组（P〉0.05）。结论：对特需门诊收治的原发性骨质疏松患者在药物治疗的基础上实施综合护理干预,能够明显提高患者的治疗依从性,提高骨密度增加比例,减少疼痛,降低骨折发生率,改善患者生活质量。

Objective： To investigate the effect of comprehensive nursing intervention on the treatment compliance and quality of life for patients with primary osteoporosis（POP） at special consultation clinic. Methods： 112 cases of POP patients admitted to the hospital during May 2010 to May 2013 year as the research object were divided into intervention group and control group, given different nursing measure on the base of drug treatment. After 6 months of intervention, POP knowledge（OKT score）, pain（VAS score）, bone mineral density（BMD） and quality of life（OQOLS score） of two groups before and after the intervention was compared. After 1 year of intervention, the treatment compliance, the incidence of fracture of two groups was evaluated. Results： After 6 months of intervention, the OKT score, VAS score and BMD of the intervention group were significantly different from before treatment（P〈0.001）, and there were also statistical difference compared to control group（P〈0.001）. The OQOLS score of 5 dimensions and total score of life quality in intervention group after intervention were statistically different from before intervention（P〈0.001）, and also statistically different from control group（P〉0.001）, while in control group, there was little change on psychological and social dimensions after intervention（P〈0.05）. Followed up for 1 year, total dependency ratio in intervention group was significantly higher than the control group, and no compliance ratio was lower than the control group（P〈0.001）; the incidence rate of pathologic fracture in intervention group was lower than control group（P〉0.05）. Conclusion： Giving comprehensive nursing intervention on the basis of drug treatment for the special consultation clinic patients with primary osteorosis, it can significantly improve the treatment compliance, improve bone mineral density,reduce pain, decrease the incidence rate of pathologic fracture, and improve the quality of life.