QQ群延伸护理服务对结核病患者健康教育的效果分析

doi:10.3969/j.issn.2096-8493.2020.03.012

摘要/Abstract

摘要：

目的分析利用互联网QQ平台对结核病患者实施健康教育及延伸护理服务的效果。方法从2017年7月开始选取在新疆维吾尔自治区胸科医院(现改为新疆医科大学第八附属医院)诊治出院的初复治结核病患者422例为研究对象(排除了年龄<15岁和>65岁、有意识障碍、精神类疾病、认知功能障碍、无正常读写能力、不能定期上网接受互联网QQ平台宣传教育及咨询者)。根据患者自愿参加、自愿入组的原则将患者纳入电话随访组(对照组,以定期电话随访进行健康教育及延伸服务)和互联网QQ平台+电话随访组(观察组,在电话随访的基础上利用互联网QQ平台实施健康教育及延伸服务),直至每组达到211例,最后纳入研究对象的时间为2018年12月。统计分析两组患者在出院3个月后的服药依从性(采用Morisky量表)、咨询服务满意度,以及在治疗过程中对饮食指导、坚持服药、康复锻炼、督促复诊、社会支持、当地复诊结果指导等方面提供干预后的改善情况。结果观察组服药依从性好的患者[63.51%(134/211)]明显高于对照组依从性好的患者[46.92%(99/211)](χ²=16.060,P=0.000);认为疾病治疗过程中对“饮食指导”[91.47%(193/211)]、“坚持服药”[80.09%(169/211)]、“康复锻炼”[77.25%(163/211)]、“对是否积极参加社会活动或继续工作与人交流”[79.62%(168/211)]、“当地复诊结果的指导”[70.62%(149/211)]干预后的改善情况明显高于对照组[分别为65.88%(139/211)、63.03%(133/211)、54.03%(114/211)、61.14%(129/211)、54.98%(116/211)](χ²=42.401,P=0.000; χ²=16.884,P=0.000; χ²=26.664,P=0.000;χ²=17.390,P=0.000;χ²=11.134,P=0.004];对延伸护理服务的满意度[96.68%(204/211)]明显高于对照组[84.36%(178/211)](χ²=18.897,P=0.000)。结论互联网QQ平台+延伸护理服务有助于提高患者及其家属对结核病防治相关知识的掌握,提高患者治疗依从性和对咨询服务工作的满意度。

关键词: 结核,肺, 病人医护管理, 健康教育, 便携式电话, 计算机通信网络, 对比研究, 数据说明,统计

Abstract:

Objective To analyze the effect of health education and extended nursing services for tuberculosis patients using internet QQ platform. Methods From July 2017 to December 2018, 422 tuberculosis patients diagnosed and discharged from the Xinjiang Uygur Autonomous Region Chest Hospital (change to the Eighth Affiliated Hospital of Xinjiang Medical University) were selected as the research subjects. Those who aged <15 years or >65 years; with consciousness disorders, mental illnesses or cognitive dysfunction; without normal reading or writing skills; cannot receive publicity, education or consultations on the internet QQ platform were excluded. Based on the principle of voluntary participation and enrollment of patients, 422 cases were divided into the telephone follow-up group (control group, regular telephone follow-up for health education and extended services, n=211) and internet QQ platform+telephone follow-up group (observation group, the health education and extended services were carried out by internet QQ platform implements and telephone). Improvements after intervention, 3-month after discharge of the two groups, including medication compliance (using the Morisky scale), satisfaction with consultation services, dietary guidance, adherence to medication, rehabilitation exercise, supervision and follow-up consultation, social support, and local follow-up consultation during treatment outcome guidance were analyzed. Results The patients with good medication compliance in the observation group were significantly higher than those in the control group (63.51% (134/211) vs. 46.92% (99/211), χ²=16.060, P=0.000). In the observation group, improvements during the disease treatment, including diet guidance, persistent on taking medication, rehabilitation exercise, actively participate in society activities or continued work to communicate with others, guide to local follow-up consultation results were all significantly higher than those in the control group (91.47% (193/211) vs. 65.88% (139/211), χ²=42.401; 80.09% (169/211) vs. 63.03% (133/211), χ²=16.884; 77.25% (163/211) vs. 54.03% (114/211), χ²=26.664; 79.62% (168/211) vs. 61.14% (129/211), χ²=17.390; 70.62% (149/211) vs. 54.98% (116/211), χ²=11.134, respectively; all P=0.000). The proportion of patients who were very satisfied with extended care services in the observation group was significantly higher than that in the control group (96.68% (204/211) vs. 84.36% (178/211), χ²=18.897, P=0.000). Conclusion The extended nursing services by internet QQ platform could help patients and their families to grasp the knowledge of tuberculosis prevention and treatment, as well as improve the compliance with treatment and satisfaction with consulting services.

Key words: Tuberculosis,pulmonary, Patient care management, Health education, Cellular phone, Computer communication networks, Comparative study, Data interpretation,statistics

安洪霞, 杨风勤, 陆川, 马秀霞. QQ群延伸护理服务对结核病患者健康教育的效果分析[J]. 结核与肺部疾病杂志, 2020, 1(3): 265-269. doi: 10.3969/j.issn.2096-8493.2020.03.012

AN Hong-xia, YANG Feng-qin, LU Chuan, MA Xiu-xia. Analysis of the effect of extended nursing service by QQ group on health education for tuberculosis patients[J]. Journal of Tuberculosis and Lung Disease, 2020, 1(3): 265-269. doi: 10.3969/j.issn.2096-8493.2020.03.012

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服药依从性	观察组(211例)		对照组(211例)		χ²值	P值
服药依从性	例数	构成比(%)	例数	构成比(%)	χ²值	P值
高	134	63.51	99	46.92	16.060	0.000
中等	71	33.65	91	43.13
低	6	2.84	21	9.95

观察项目	观察组(211例)			对照组(211例)			χ²值	P值
观察项目	帮助很大	一般帮助	没有帮助	帮助很大	一般帮助	没有帮助	χ²值	P值
饮食指导	193(91.47)	18(8.53)	0(0.00)	139(65.88)	65(30.80)	7(3.32)	42.401	0.000
坚持服药	169(80.09)	40(18.96)	2(0.95)	133(63.03)	68(32.23)	10(4.74)	16.884	0.000
康复锻炼	163(77.25)	47(22.27)	1(0.48)	114(54.03)	90(42.65)	7(3.32)	26.664	0.000
督促复诊	133(63.03)	76(36.02)	2(0.95)	134(63.51)	71(33.65)	6(2.84)	2.174	0.342
积极参加社会活动或继续工作与人交流	168(79.62)	41(19.43)	2(0.95)	129(61.14)	77(36.49)	5(2.37)	17.390	0.000
咨询当地复诊结果	149(70.62)	57(27.01)	5(2.37)	116(54.98)	86(40.76)	9(4.26)	11.134	0.004

满意度	观察组(211例)		对照组(211例)		χ²值	P值
满意度	例数	构成比(%)	例数	构成比(%)	χ²值	P值
非常满意	115	54.50	96	45.50	18.897	0.000
满意	89	42.18	82	38.86
不满意	7	3.32	33	15.64