患者关爱与支持管理模式对结核病患者自律性和自我效能的影响

The effect of patient care and support management model on the self-discipline and self-efficacy of tuberculosis patients

目的:探究患者关爱与支持管理模式对结核病患者自律性和自我效能的影响。方法:采用前瞻性研究方法,参照入组标准选择2021年11月1日至2022年5月24日在安徽省胸科医院住院的118例结核病患者,按入院日期交替分组为观察组62例(实施个案管理、健康教育、心理支持生活管理等关爱与支持管理干预)和对照组56例(接受常规护理)。对比两组患者的自律性评分、自我效能评分、生命质量评分、护理满意度。在研究结束时,观察组和对照组分别脱落4例和5例。结果:对照组患者入院时的自律性评分为(89.48±5.26)分、日常生活评分为(8.99±1.44)分、健康行为评分为(9.86±0.98)分、遵医行为评分为(10.28±0.74)分、生命质量测定(QLICD-PT)评分为(122.35±14.16)分,观察组自律性评分为(88.36±4.93)分、日常生活评分为(9.35±1.35)分、健康行为评分为(10.19±1.15)分、遵医行为评分为(10.05±0.76)分、QLICD-PT评分为(121.48±15.93)分,差异均无统计学意义(t值分别为1.143、1.346、1.601、1.296、0.300,P值均>0.05);出院后1个月观察组患者自律性评分为(109.74±5.25)分、日常生活评分为(15.59±1.17)分、健康行为评分为(16.16±2.42)分、遵医行为评分为(17.41±1.85)分,以及QLICD-PT评分为(161.56±13.39)分,均明显高于对照组[自律性评分为(95.69±4.97)分、日常生活评分为(13.16±1.05)分、健康行为评分为(13.45±1.94)分、遵医行为评分为(14.38±1.32)分和QLICD-PT评分为(143.63±15.45)分],差异均有统计学意义(t值分别为14.292、11.348、6.392、9.927和6.491,P值均<0.001)。观察组护理满意度为98.28%(57/58),高于对照组(88.24%,45/51),差异有统计学意义(χ^(2)=4.552,P=0.033)。结论:患者关爱与支持管理模式能够帮助结核病患者改善心理状况,可有效提升患者健康认知水平,增强自我管理能力,有助于提高院外生活的自律性和自我效能,能够改善患者院后的生命质量,提升治疗依从性,护理满意度较高。

Objective:To explore the effect of patient care and support management model on the self-discipline and self-efficacy of tuberculosis patients.Methods:A prospective study was designed to select 118 tuberculosis patients admitted to Anhui Chest Hospital from November 1,2021 to May 24,2022 according to an inclusion criteria,62 cases were allocated into observation group(receiving care and support management intervention such as case management,health education,psychological support and life management)and 56 cases were allocated into control group(receiving routine nursing)according to their date of admission.The scores of self-discipline,self-efficacy,quality of life and nursing satisfaction were compared between the two groups.At the end of the study,4 and 5 cases defaulted in the observation and control group,respectively.Results:The scores of self-discipline,daily life,health behavior,compliance behavior,quality of life(QLICD-PT)in control group were 89.48±5.26,8.99±1.44,9.86±0.98,10.28±0.74 and 122.35±14.16 respectively at admission,and in observation group they scored 88.36±4.93,9.35±1.35,10.19±1.15,10.05±0.76 and 121.48±15.93 respectively.The differences were not statistically significant(t=1.143,1.346,1.601,1.296 and 0.300 respectively,all Ps>0.05).One month after discharge,the scores of self-discipline(109.74±5.25),daily life(15.59±1.17),health behavior(16.16±2.42),compliance behavior(17.41±1.85)and QLICD-PT(161.56±13.39)in observation group were significantly higher than those of control group which scored 95.69±4.97,13.16±1.05,13.45±1.94,14.38±1.32 and 143.63±15.45 respectively(t=14.292,11.348,6.392,9.927 and 6.491,respectively,all Ps<0.001).The nursing satisfaction of the observation group(98.28%,57/58)was also significantly higher than that of the control group(88.24%(45/51)(χ^(2)=4.552,P=0.033).Conclusion:Patient care and support management model could help TB patients to improve their psychological condition,could effectively improve patients’health cognition level,enhance self-management ability,help to improve the self-discipline of out-hospital life and self-efficacy,could improve the quality of life after hospitalization,improve treatment compliance,and the nursing satisfaction was high.