糖尿病并发肺结核老年患者健康素养与治疗效果的关系

An analysis on the relationship between health literacy level and prognosis in elderly patients with diabetes mellitus complicated with pulmonary tuberculosis

目的研究糖尿病并发肺结核老年患者健康素养与治疗效果的关系,为提高肺结核治疗效果提供依据。方法采用方便抽样方法选取在遵化市人民医院治疗的糖尿病并发肺结核患者214例进行随访;采用健康素养量表、治疗依从性量表进行评价,结合肺结核病灶和血糖控制情况分析患者的健康素养水平与治疗依从性及预后的关系。结果高健康素养组患者结核病灶控制总有效率为83.65%,血糖控制达标率为92.30%,均高于低健康素养组的60.00%和67.27%(P<0.05);多因素Logistic回归分析结果显示高健康素养(OR=0.570,95%CI:0.380~0.886)和高治疗依从性(OR=0.215,95%CI:0.052~0.884)是糖尿病并发肺结核患者治疗预后的保护因素;而女性(OR=1.806,95%CI:1.175~2.776)、空洞型肺结核(OR=3.005,95%CI:1.369~6.598)、合并其他疾病(OR=1.582,95%CI:1.039~2.408)、血糖控制不良(OR=2.241,95%CI:1.328~3.386)、营养风险评分≥3分(OR=2.371,95%CI:1.387~4.052)以及家庭功能总评分<3分(OR=1.624,95%CI:1.092~2.461)是糖尿病并发肺结核患者治疗预后的危险因素。高健康素养组患者的吸烟、饮酒、饮食、康复锻炼和用药情况均优于低健康素养组(P<0.05)。结论糖尿病并发肺结核患者的肺结核治疗效果与健康素养有关,健康素养越高,治疗依从性越好,预后愈佳。

Objective To investigate the relationship between health literacy and prognosis in patients with diabetes combined tuberculosis,and in order to provide the reference for improving treatment compliance in patients with diabetes combined tuberculosis. Methods Totally 214 cases of patients with diabetes combined tuberculosis were selected as the objectives and their literacy level,compliance scale with the health literacy scale and compliance questionnaires were evaluated. We analyzed the relationship among health literacy and treatment compliance and prognosis combining the patient＇s condition of lesions,blood sugar control in patients with diabetes combined tuberculosis. Results The efficacy of pulmonary tuberculosis control and blood sugar control were 83. 65% and 92. 30% respectively in high health literacy group,which were higher than in health literacy group（ 60. 00% and 67. 27%,P〈0. 05）. Logistical regression analysis showed that the higher health literacy level（ OR = 0. 570,95% CI： 0. 380- 0. 886） and higher treatment compliance（ OR =0. 215,95% CI： 0. 052- 0. 884） were the protective factors for prognosis; while female（ OR = 1. 806,95% CI： 1. 175-2. 776）,cavity pulmonary tuberculosis（ OR = 3. 005,95% CI： 1. 369- 6. 598）,combined other diseases（ OR = 1. 582,95% CI： 1. 039- 2. 408）,poor control of blood glucose（ OR = 2. 241,95% CI： 1. 328- 3. 386）,nutritional risk score≥3（ OR = 2. 371,95% CI： 1. 387- 4. 052） and general family assessment score 〈3（ OR = 1. 624,95% CI： 1. 092-2. 461） were the risk factors for prognosis. The compliance behaviors such as smoking,drinking,diet,rehabilitation exercise and medication in high health literacy group were better than in low health literacy group（ P〈0. 05）.Conclusion The higher the level of health literacy in elderly patients with diabetes combined tuberculosis and the compliance,the better the prognosis.