耐药结核病患者的护理干预研究

Research on the nursing intervention in patients with drug-resistant tuberculosis

目的探讨耐药结核病患者的护理干预研究。方法将2018年11月~2019年10月在我院治疗的60例耐药结核病患者,随机分为两组,对照组采用常规护理,观察组采用个体化护理干预,比较两组的症状自评量表(SCL-90)评分变化、治疗依从性、生活质量综合评定问卷-74(GQOLI-74)评分变化、痰菌阴转率和病灶吸收率。结果观察组护理后人际关系、强迫、偏执、恐怖、躯体化、敌意、精神病性等SCL-90评分与对照组比较,差异无统计学意义(P>0.05),而焦虑、抑郁评分明显低于对照组(P<0.05);观察组遵医嘱规律用药、合理饮食、坚持锻炼、定期行肝功能检查、定期行胸部CT检查等治疗依从性评分明显高于对照组(P<0.05);观察组治疗后心理健康、躯体健康、社会功能、物质生活等GQOLI-74评分明显高于对照组(P<0.05);观察组护理16、20、24周的痰菌阴转率和病灶吸收率高于对照组(P<0.05),而两组护理12周的痰菌阴转率和病灶吸收率比较,差异无统计学意义(P>0.05)。结论耐药结核病患者的个体化护理干预效果显著,能有效减少患者焦虑、抑郁的心理状态,提高治疗依从性,提升痰菌阴转率和病灶吸收率,改善生活质量,具有积极的临床意义。

Objective To explore the nursing intervention in patients with drug-resistant tuberculosis.Methods From November 2018 to October 2019,A total of 60 patients with drug-resistant tuberculosis admitted to our hospital were randomly divided into the control group,which was given routine nursing,and the observation group,which was given individualized nursing intervention.The changes of symptom checklist 90(SCL-90)score,therapy adherence,generic quality of life inventory 74(GQOLI-74)score,sputum negative conversion rate and focus absorption rate were compared between the two groups.Results Compared with the control group,there was no statistically significant differences(P>0.05)in the SCL-90 scores of interpersonal relationship,compulsion,paranoia,terror,somatization,hostility and psychosis in the observation group,while the scores of anxiety and depression were significantly lower than those in the control group(P<0.05).The therapy adherence scores of the observation group,such as regular medication,reasonable diet,persistent exercise,regular liver function examination and regular chest CT examination,were significantly higher than those of the control group(P<0.05).After treatment,GQOLI-74 scores of mental health,physical health,social function and material life in the observation group were significantly higher than those in the control group(P<0.05).The sputum negative conversion rates and focus absorption rates of the observation group after 16,20 and 24 weeks of nursing were higher than those of the control group(P<0.05),but there were no significant differences of two groups between the sputum negative conversion rate and focus absorption rate after 12 weeks of nursing(P>0.05).Conclusion Individualized nursing intervention for drug-resistant tuberculosis patients is effective,which effectively reduces the psychological state of anxiety and depression,improves therapy adherence,increases sputum negative conversion rate and focus absorption rate,and raises the quality of life.Therefore,it is of positively clinical significance.