关键词: 结核, 抗多种药物性, 护理方法学研究, 药物治疗依从性, 生活质量, 评价研究

Abstract:

Objective To explore the role of extended nursing on multidrug-resistant tuberculosis (MDR-TB) patients’ treatment compliance and life quality.Methods A total of 110 MDR-TB patients who admitted to the Shandong Provincial Chest Hospital from January 2015 to March 2016 were included in this study. According to their admission numbers (odd or even), the patients were divided into routine nursing group (RNG) and extended nursing group (ENG) (55 patients in each group). Patients in the RNG were routinely followed-up, whereas those in the ENG were given extended care after discharge, respectively. The study was approved by the Ethical Committee of Shandong Provincial Chest Hospital. Data on their missed medications, timeliness of clinical revisits, and measurements of life quality (assessed by 4 indicators of the SF-36 health survey scale, including vitality, social functioning, mental health and general health) 6 months after discharge were collected and analyzed.Results During the first 6 months’ treatment after discharge, in the ENG, one case died, one moved and one was lost to follow up, and consequently 52 patients were included in this analysis; in the RNG, two patients were lost to follow up, and eventually 53 patients were included in the analysis. The proportion of participants who had not missed any single dosage was higher in the ENG (84.6%, (44/52) compared to the RNG (58.5%, 31/53). The difference was statistically significant (χ ²=8.13, P=0.004). 94.2% (49/52) ENG participants made their revisits regularly, which was significantly higher compared with RNG (77.4%, 41/53). The difference was statistically significant (χ ²=6.10, P=0.023). The scores of the 4 indicators of SF-36 health survey scale including vitality, social functioning, mental health and general health in the ENG at 3-month time-point ((37.05±1.05), (38.98±1.23), (40.05±1.07) and (51.08±2.08)) and 6-month time-point after discharge ((40.23±1.57), (40.29±2.03), (41.95±1.27) and (53.04±2.09)) were significantly higher than those of the RNG at 3-month time-point ((34.01±1.05), (35.12±1.06), (39.23±2.02) and (43.01±1.08)) and at 6-month time-point ((32.89±2.02), (36.07±1.99), (38.85±1.68) and (45.04±2.17)), and the differences were statistically significant (3-month: t=14.83, 17.24, 2.59, 25.02; P=0.005, 0.005, 0.042, 0.006; 6-month: t=20.76, 10.76, 10.65, 19.24; P=0.007, 0.006, 0.003, 0.006).Conclusion Extended nursing is an effective new tool to improve MDR-TB patients’ treatment compliance and life quality. It is necessary to formulate standard nursing services package in the future.

Key words: Tuberculosis, multidrug-resistant, Nursing methodology research, Medication adherence, Quality of life, Evaluation studies