摘要
目的探讨实施多元化护理干预措施对耐多药肺结核（MDR-PTB）患者呼吸功能锻炼依从性的影响。方法参照纳入及排除标准，选取2015年10月至2017年9月西安市胸科医院耐药结核科收住入院的123例肺功能损伤的MDR-PTB患者，行呼吸功能锻炼方面的护理干预。其中2015年10月至2016年9月的54例IVIDR-PTB患者（对照组）采用住院期间责任护士口头进行结核病相关知识宣传教育、呼吸功能锻炼教授、出院发放健康教育处方及提醒锻炼与复查等方式进行护理干预；对于2016年10月至2017年9月的69例MDR-PTB患者（观察组），除采取以上措施外，还采取呼叫器广播教育、播放视频教育、发放健康教育宣传册、展示宣传教育（以下简称“宣教”）栏、进行多媒体健康教育座谈（包括微信群、公众号），以及护士带领下采用呼吸操进行功能锻炼等多种全面、有效的干预措施。在患者出院后3个月复查期间，通过面对面沟通交流的方式，对123例患者就呼吸功能锻炼的依从性、方法和知识掌握，以及对护士工作满意度等情况进行调查。使用SPSS18．0软件进行统计分析，对两组患者计数资料采用χ2检验，均以P〈0．05为差异有统计学意义。结果观察组呼吸功能锻炼依从率[81．16％（56／69）]、呼吸功能锻炼方法掌握率[84．06%（58／69）]、疾病与呼吸功能锻炼相关知识知晓率[81．16％（56／69）]、对护理工作满意率[94．20％（65／69）]均明显高于对照组[分别为53．70％（29／54）、51．85％（28／54）、64．81％（35／54）、81．48％（44／54）]，差异均有统计学意义（χ2=10．70，P=0．001；χ2=14．39，P=0．000；χ2=4．20，P=0．040；χ2=4．86，P=0．027）。两组患者未进行呼吸功能锻炼的原因分别为“认为无效果”[44．74％（17／38）]、“无时间”[7．89％（3／38）]、“方法未掌握”[10．53％（4／38）]、“病情原因”[15．79％（6／38）]、“无人督导”[15．79％（6／38）]、“其他”[5．26％（2／38）]。结论实施更加多元化的护理干预措施能够显著提高MDR-TB患者对呼吸功能锻炼方法的掌握率，及相关知识的知晓率，进而提高其对呼吸功能锻炼的依从性和对医护工作的满意度。
Objective To explore the effect of diverse nursing intervention measures on respiratory function exercise of MDR-TB （multidrug-resistant tuberculosis） patients. Methods A total of 123 inpatients with MDR-TB were enrolled in Xi＇an Chest Hospital from Oct 2015 to Sep 2017. Fifty four cases of MDR-PTB inpatients from Oct 2015 to Sep 2016 （control group） were educated tuberculosis knowledge by nurses and breathing function exercise during hospitalization. Meanwhile, they were provided health education prescriptions and reminded exercise after discharged from hospital and required rechecking. Sixty nine cases of MDR-PTB inpatients from Oct 2016 to Sep 2017 （observation group） received more comprehensive and effective intervention measures including education in beeper, respiratory function training in video, health education in brochures and bulletin board, multimedia health education symposium （WeChat group, Wechat Official Account） and learning breathing exercise from nurses. One hundred and twenty-three patients were investigated about compliance, methods and knowledge of respiratory func- tion exercise by face-to-face communication after 3 months discharge. SPSS 18.0 software was used for statistics, and counting data were tested by chi square test. P 〈0. 05 was as the significant difference statistically. Results The compliance rate of respiratory function exercise （81.16%（56/69））, mastery rate of respiratory func-tion exercise （84.06% （58/69））, awareness rate of knowledge of disease and respiratory function exercise （81.16 % （56/69））, the rate of satisfaction with nursing work （94.20 % （65/69）） in observation group were higher than that in the control （53.70% （29/54）,51. 85% （28/54）, 64.81% （35/54）, 81.48% （44/54））（χ2=10. 70,P= 0.001;χ2=14.39,P=0.000;χ2=4.20,P=0.040;χ2=4.86,P=0.027, respectively）. The reasons for the two groups of patients who did not exercise respiratory function were ＂it is considered ineffective ＂（44.74% （17/38）） ,＂ no time ＂（7.89% （3/38））,＂ method not mastered ＂（10. 53% （4/38））,＂ cause of disease ＂（15.79% （6/38））,＂ unsupervised ＂（15. 79% （6/38））＂ and ＂other＂ （5.26% （2/38））, respectively. Conclusion Diversified nursing intervention can significantly improve the compliance of the MDR-TB patients with respiratory function exercise and the satisfaction to health care work.
作者
姜雪姣
任斐
许优
杨玲
JIANG Xue-jiao, REN Fei, XU You, YANG Ling.(Department of Drug-resistant Tuberculosis, Xi＇ an Chest Hospital, Xi ＇ an 710100, Chin)
出处
《结核病与肺部健康杂志》
2018年第1期37-43,共7页
Journal of Tuberculosis and Lung Health
关键词
结核
肺
护理教育研究
结核
抗多种药物性
呼吸锻炼
病人依从
Tuberculosis, pulmonary
Nursing education research
Tuberculosis, multidrug resistant
Breathing exercise
Patient compliance
