SystemCHANGE模式在耐多药肺结核患者服药管理中的应用

Application of SystemCHANGE Model in Medication Management of Multi-drug Resistant Tuberculosis Patients

目的探讨SystemCHANGE模式在耐多药肺结核患者服药管理中的应用效果。方法将南华大学附属长沙中心医院2018-10/2019-08收治的87例耐多药肺结核患者随机分为试验组和对照组,对照组进行常规护理和随访,试验组在此基础上采用SystemCHANGE模式的服药管理。比较两组患者服药依从性得分、痰液转阴率和病灶吸收效果。采用SPSS 25.0软件对数据进行χ^(2)检验。结果两组患者出院时和出院1个月的服药依从性得分差异无统计学意义(P>0.05),试验组出院3、6个月的服药依从性得分均高于对照组(P<0.05)。重复测量方差分析结果显示,两组服药依从性得分在时间、组间效应及两者交互作用均有统计学意义(P<0.01)。试验组干预后的痰液转阴率和病灶吸收效果均优于对照组(P<0.05)。结论采用System CHANGE模式的服药管理可有效提高耐多药肺结核患者的服药依从性,改善治疗效果。

Objective To explore the effect of the SystemCHANGE model in medication management for patients with multi-drug resistant tuberculosis(MDR-TB).Methods The 87 patients with MDRTB treated in Changsha Central Hospital affiliated to The University of South China from October 2018 to August 2019 were randomly divided into a test group and a control group,and the control group was given routine nursing and follow-up.Based on this,the test group adopted the medication management of the System CHANGE model.The two groups of patients were compared for medication compliance score,sputum negative conversion rate,and lesion absorption effect.SPSS 25.0 software was used for chi-square test.Results There was no significant difference in medication compliance scores between the two groups of patients at discharge and 1 month after discharge(P>0.05).The medication compliance scores of the test group at 3 and 6 months after discharge were higher than those of the control group(P<0.05).The results of repeated measures anova showed that the medication compliance scores of the two groups were statistically significant in time effect,inter-group effect,and interaction between the two(P<0.001).The sputum negative conversion rate and lesion absorption effect of the test group were better than those of the control group after intervention(P<0.05).Conclusion The medication management using the SystemCHANGE mode can effectively improve medication compliance and improve the treatment effect of patients with MDR-TB.