叙事护理联合同伴教育在耐多药肺结核患者中的应用

Application of narrative nursing combined with peer education in patients with multi-drug-resistant pulmonary tuberculosis

目的探讨叙事护理联合同伴教育在服用环丝氨酸的耐多药肺结核患者中的应用效果。方法选择2019年1月至2022年12月陕西省结核病防治院收治的106例耐多药肺结核患者作为研究对象,根据随机数表法将患者分为研究组和对照组,每组53例。对照组患者给予同伴教育,观察组患者给予叙事护理联合同伴教育。护理两周后比较两组患者的病灶吸收情况,记录护理前、护理两周后两组患者的汉密尔顿抑郁量表(HAMD)、知觉心理压力量表(CPSS)、简明生活质量量表(SF-36)变化,并统计两组患者对护理的依从性。结果观察组患者的病灶吸收总有效率为92.45%,明显高于对照组的75.47%,差异有统计学意义(P<0.05);护理前,两组患者的HAMD、CPSS评分比较差异均无统计学意义(P>0.05),护理后,两组患者的HAMD、CPSS评分均显著降低,且观察组分别为(8.29±1.83)分、(26.17±3.09)分,明显低于对照组的(14.28±1.90)分、(32.17±4.21)分,差异均有统计学意义(P<0.05);护理前,两组患者的SF-36评分比较差异无统计学意义(P>0.05),护理后,两组患者的SF-36评分均显著升高,且观察组患者的社会功能、生理功能、心理健康、物质生活评分分别为(23.18±3.11)分、(24.10±3.74)分、(22.75±2.84)分、(23.61±3.07)分,明显高于对照组的(19.37±2.90)分、(17.35±3.04)分、(18.75±2.69)分、(20.17±2.63)分,差异均有统计学意义(P<0.05);观察组患者对护理的依从率为90.57%,明显高于对照组的77.36%,差异有统计学意义(P<0.05)。结论叙事护理联合同伴教育应用于耐多药肺结核患者中可促进病灶吸收,缓解患者负面情绪,提高患者的生活质量及护理依从性。

Objective To explore the application effect of narrative nursing combined with peer education in patients with multidrug-resistant pulmonary tuberculosis taking cycloserine.Methods A total of 106 patients with multi-drug-resistant pulmonary tuberculosis admitted to Shaanxi Provincial Tuberculosis Control Hospital from January 2019 to December 2022 were selected as the study objects.According to the random number table,they were divided into a study group and a control group,with 53 patients in each group.The patients in the control group received peer education,while patients in the observation group received narrative nursing combined with peer education.After 2 weeks of nursing care,the absorption of lesion was compared between the two groups.The changes in Hamilton Depression Scale(HAMD),Chinese Perceived Stress Scale(CPSS),and Short Form 36 Health Survey(SF-36)were recorded before and after 2 weeks of nursing,and the compliance of the two groups of patients with nursing was counted.Results The total effective rate for absorption of lesion in the observation group was 92.45%,which was significantly higher than 75.47%in the control group(P<0.05).Before nursing,there was no significant difference in HAMD and CPSS scores between the two groups(P>0.05).After nursing,the HAMD and CPSS scores of two groups were significantly decreased,and those in the observation group were(8.29±1.83)points,(26.17±3.09)points,which were significantly lower than(14.28±1.90)points,(32.17±4.21)points in the control group(P<0.05).Before nursing,there was no significant difference in SF-36 score between the two groups(P>0.05).After nursing,the SF-36 scores of two groups were significantly increased,and the social function,physiological function,mental health,and material life scores in the observation group were(23.18±3.11)points,(24.10±3.74)points,(22.75±2.84)points,(23.61±3.07)points,which were significantly higher than(19.37±2.90)points,(17.35±3.04)points,(18.75±2.69)points,and(20.17±2.63)points in the control group(P<0.05).The compliance rate of nursing in the observation group was 90.57%,which was significantly higher than 77.36%in the control group(P<0.05).Conclusion The application of narrative nursing combined with peer education in patients with multidrug-resistant pulmonary tuberculosis can promote the absorption of lesions,alleviate the negative emotions of patients,and improve the quality of life and nursing compliance of patients.