多学科过渡护理对艾滋病患者护理参与、护理延续及病毒抑制的影响

Effect of multi-disciplinary transitional nursing on nursing participation,nursing continuity and virus inhibition of AIDS patients

目的探讨多学科过渡护理对艾滋病患者护理参与、护理延续及病毒抑制的影响。方法选取2014年3月至2018年3月大连市第六人民医院感染科住院并确诊为艾滋病的患者322例,用随机数字表法将患者随机分为普通护理组与多学科过渡护理组各161例。记录每例患者的人口统计学、临床数据,并做比较,记录患者难以参与护理和医疗咨询的障碍。向患者咨询住院前护理参与、护理延续的次数。随访1年之后,记录每例患者护理参与、护理延续及病毒抑制的情况。比较每组上述指标前后差异。将多学科过渡护理组患者出院之后分为3个亚组,做亚组之间的比较,并加人到多因素分析,做二元Logistic回归。结果多学科过渡护理组在出院后1年的护理参与、护理延续例数分别为119例(81.51%,119/146),105例(71.92%,105/146),普通护理组在出院后1年的护理参与例数、护理延续例数分别为100例(62.11%,100/161),90例(55.90%,90/161),2组比较差异有统计学意义(x^(2)值为14.09、8.48,P<0.05)。多学科过渡护理组组内不咨询例数亚组,仅医疗和护理咨询亚组和医疗、护理和社会支持咨询亚组在护理参与、护理延续和病毒抑制增加例数上比较差异有统计学意义(x^(2)值为22.90、37.21、23.07,P<0.05)。回归模型结果提示仅医疗和护理咨询的患者,医疗、护理和社会咨询的患者相对于不咨询的患者护理参与的O/R值分别为1.67、1.89,护理延续的O/R值分别为1.21、1.98,病毒抑制的O/R值分别为1.35、1.76,差异有统计学意义。结论通过多学科过渡护理,能够显著提高艾滋病患者的护理参与度,护理延续度,同时能够提高病毒抑制。

Objective To explore the impact of multidisciplinary transitional nursing on AIDS patients'nursing participation,nursing continuation and virus suppression.Methods A total of 322 patients with AIDS who were hospitalized in the Infection Department of Dalian Sixth People's Hospital from March 2014 to March 2018 were selected and randomly divided into general nursing group and multidisciplinary transitional nursing group with 161 cases in each group.The demographic and clinical data of each patient were recorded and compared,and the barriers of patients to participate in nursing and medical consultation were recorded.Consulted The patients were consulted about the nursing participation before hospitalization and the times of nursing continuation.After one year of follow-up,the number of cases of nursing participation,nursing continuity and virus suppression were recorded.The differences between the two groups were compared.The patients in the multidisciplinary transitional care group were divided into three subgroups after discharge,and the comparison between the subgroups was made.Multivariate Logistic regression analysis was performed.Results In the multidisciplinary nursing group,119 cases(81.51%,119/146)and 105 cases(71.92%,105/146)were involved in nursing and 105 cases(71.92%,105/146)in the multidisciplinary nursing group,and 100 cases(62.11%,100/161)and 90 cases(55.90%,90/161)in the general nursing group 1 year after discharge,respectively.The difference between the two groups was statistically significant(x^(2) value was 14.09,8.48,P<0.05).There was a significant difference in the number of cases in the multidisciplinary transitional care group without consulting the subgroup,only the medical and nursing consulting subgroup and medical,and the nursing and social support consulting subgroup in nursing participation,nursing continuation and increased viral suppression (x^(2) value was 22.90,37.21,23.07,P<0.05).The results of the regression model suggested that patients with medical and nursing consultation only,patients with medical,nursing,and social consultation had OR value of 1.67 and 1.89 compared with patients without consultation.The OR value was 1.35 and 1.76,which were significantly different.Conclusions Through multidisciplinary transitional nursing,it can significantly improve nursing participation and nursing continuity and can improve virus suppression.