护士-家属协同督导模式在老年肺结核患者中的应用

Application of the collaborative nurse-family supervision model in elderly patients with pulmonary tuberculosis

目的探讨护士-家属协同督导模式在老年肺结核患者中的应用价值。方法选取2018年9月-2020年10月河南省某医院收治的86例老年肺结核患者,采用随机数字表法分为观察组与对照组,每组43例。对照组患者采用常规护理,观察组患者在对照组基础上采用护士-家属协同督导模式。比较2组患者的胸部X线病灶吸收情况、再入院率及干预前后的遵医行为、自我效能、肺功能[第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)]。结果2组患者干预后遵医行为量表中合理膳食、规范用药、戒烟戒酒维度评分高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组患者干预后GSES评分高于干预前,且观察组高于对照组,差异均有统计学意义(t=7.481,P<0.001)。观察组患者干预后肺部病灶吸收率为90.70%,高于对照组的67.44%,差异有统计学意义(χ^(2)=7.027,P=0.008)。2组患者干预后FEV1、FEV1/FVC水平高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。观察组患者随访1年再入院率为9.30%(4/43),低于对照组的25.58%(11/43),差异有统计学意义(χ^(2)=3.957,P=0.047)。结论护士-家属协同督导模式有利于提高老年肺结核患者自我效能,改善患者遵医行为及肺功能,降低再入院率。

Objective To explore the application value of the collaborative nurse-family supervision model in elderly patients with pulmonary tuberculosis.Methods Eighty-six cases of elderly patients with pulmonary tuberculosis admitted to a hospital in Henan province from September 2018 to October 2020 were selected and divided into an observation group and a control group using the random number table method,with 43 cases in each group.Patients in the control group were given conventional care,and patients in the observation group received the collaborative nurse-family supervision model on the basis of the control group.Patients in the two groups were compared in terms of chest X-ray lesion absorption,readmission rate,compliance behavior,self-efficacy,and pulmonary function[forced expiratory volume in the first second(FEV1),FEV1/forced vital capacity(FVC)]before and after the intervention.Results The scores for the rational diet,standardized medication and smoking and alcohol cessation dimensions in the post-intervention compliance scale were higher in the 2 groups than before the intervention,and were higher in the observation group than in the control group,with statistically significant differences(P<0.05).The scores of GSES were higher in the 2 groups than before the intervention,and were higher in the observation group than in the control group,with statistically significant differences(t=7.481,P<0.001).The lung lesion absorption rate of patients in the observation group was 90.70%after the intervention,which was higher than that of the control group(67.44%),and the difference was statistically significant(χ^(2)=7.027,P=0.008).FEV1 and FEV1/FVC levels of patients in the 2 groups were higher than those before the intervention,and the observation group was higher than the control group,and the differences were statistically significant(P<0.05).The 1-year follow-up readmission rate of patients in the observation group was 9.30%(4/43),which was lower than that of the control group(25.58%,11/43),and the difference was statistically significant(χ^(2)=3.957,P=0.047).Conclusion The collaborative nurse-family supervision model is beneficial for improving self-efficacy,improving patient compliance behavior and pulmonary function,and reducing readmission rates in elderly patients with pulmonary tuberculosis.