影响肺结核患者遵医行为相关因素分析及护理对策

Analysis of Related Factors Affecting Compliance Behavior of Pulmonary Tuberculosis Patients Nursing Countermeasures

目的分析可能影响肺结核患者遵医行为的危险因素,探讨改善肺结核患者遵医行为的护理对策。方法选取2019年2月至2022年1月在厦门大学附属第一医院杏林分院就诊的肺结核患者105例作为调查对象,跟踪随访患者1年的治疗情况,并对遵医行为作出评价,根据遵医行为评价情况分为遵医组(62例)和不遵医组(43例)。对两组患者的流行病学资料、疾病资料进行分组统计,采用多因素Logistic系统进行影响遵医行为的危险因素分析,根据结果探讨改善肺结核患者遵医行为的护理对策。结果经多因素Logistic分析显示,文化程度低于初中(OR 1.142,95%CI 1.324~4.352)、疾病相关知识认知水平不合格(OR 1.236,95%CI 1.127~4.937)、经济收入<8000元/月(OR 1.208,95%CI 1.118~3.274)、无医保(OR 1.258,95%CI 1.023~3.238)、出现药物不良反应(OR 1.249,95%CI 1.143~3.641)、社会支持度<20分(OR 1.318,95%CI 1.028~3.473)是影响肺结核患者遵医行为的独立危险因素。结论肺结核患者遵医行为状况不容乐观,需要从健康指导、合理用药指导、心理干预、家庭支持等多方面入手,提升患者疾病认知水平,促进健康意识,提升其遵医行为。

Objective To analyze the risk factors that may affect the compliance behavior of patients with pulmonary tuberculosis,and to explore the nursing countermeasures to improve the compliance behavior of patients with pulmonary tuberculosis.Methods A total of 105 patients with pulmonary tuberculosis attending Xinglin Branch of the First Affiliated Hospital of Xiamen University from February 2019 to January 2022 were selected as the survey object,and the patients were tracked and followed up for 1 year and evaluated for medical compliance behavior,and were divided into the medical compliance group(62 cases)and the non-compliance group(43 cases)based on the evaluation of medical compliance behavior.The epidemiological data and disease data of the two groups were grouped and counted,and the risk factors affecting medical compliance were analyzed using the multifactorial logistic system,and the nursing countermeasures to improve the compliance behavior of patients with tuberculosis were explored according to the results.Results The multifactorial logistic analysis showed that the literacy level was lower than junior high school(OR 1.142,95%CI 1.324-4.352),the cognitive level of disease-related knowledge was not qualified(OR 1.236,95%CI 1.127-4.937),the economic income was less than 8,000 yuan/month(OR 1.208,95%CI 1.118-3.274),no medical care was available,and the patients had no medical care.3.274),no health insurance(OR 1.258,95%CI 1.023-3.238),occurrence of adverse drug reactions(OR 1.249,95%CI 1.143-3.641),and social support<20 points(OR 1.318,95%CI 1.028-3.473)were independent risk factors affecting the compliance behavior of TB patients.Conclusions The status of compliance behavior of tuberculosis patients is not optimistic,and it is necessary to start from various aspects such as health guidance,rational medication guidance,psychological intervention,family support,etc.,to improve the level of patients'disease cognition,to promote health awareness,and to improve their compliance behavior.