家庭督导员影响新发肺结核患者治疗依从性研究  

STUDY OF THE INFLUENCE OF FAMILY OBSERVERS ON NEW TB PATIENTS' TREATMENT COMPLIANCE

作　　者：王耶盈[1] 何朝阳[1] 李武[2] 叶勇[3] 蒋云春 刘华兴 

机构地区：[1]昆明医学院公共卫生学院流行病学教研室,昆明650031 [2]昆明医学院第一附属医院 [3]普洱市疾病预防控制中心 [4]勐腊县疾病预防控制中心

出　　处：《现代预防医学》2009年第21期4113-4115,4118,共4页Modern Preventive Medicine

摘　　要：[目的]了解家庭督导员结核病相关知识掌握情况以及对督导工作的态度,并探求家庭督导员对患者治疗依从性的影响因素。[方法]利用自行设计流行病学问卷入户面对面调查肺结核强化治疗末期患者家庭督导员的基础资料、结核病相关知识以及对督导工作的态度。同时,在没有提前通知的情况下,以药片计数法调查患者依从性。[结果]家庭督导员绝大多数为患者近亲,文化程度和家庭收入较低。家庭督导员结核病相关知识掌握情况不理想,回答正确率在63.1%至90%之间。督导态度方面,97%的督导员在对患者进行督导时感觉"一般及高兴"。在多因素分析中少数民族(OR=0.43)、未婚(OR=0.10)、家庭收入在500～1000元之间(OR=0.28)为治疗依从性的有益因素;结核病知识的错误认识是主要的危险因素之一。[结论]各级结核病管理者应该提高家庭督导员对患者的依从性重要作用的认识,加强督导员在结核病相关知识方面的培训。[Objectives] To know the TB knowledge and the attitude towards DOT among family observers, and explore the influence factors of TB patients＇ compliance through family observers. [Methods] Family observers whose patients were in the last phase of the intensive treatment were interviewed at their homes with by self-designed questionnaire. Tablet counting method was used to evaluate patients＇ comphance without prior informing. [Results] Most of family observers were patients＇ relatives with low education and family income level. The levels of TB knowledge of observers were far from the expectation, and the correction rates were from 63.1% to 90%. 97% of the observers felt ＇general and happy＂ when they observed patients. Influence factors of treatment compliance were analyzed by Logistic regression to find that minority （OR = 0.43）, single （OR = 0.10）, and family income at 500-1 000 yuans level （OR= 0.28） were favourable factors, and misunderstanding of TB related knowledge were the main risk factor for patients＇ compliance. [Conclusion] TB management at every level should work to enhance family observers＇ effect on patients＇ comphance and reinforce the related training among observers.

关 键 词：依从性 肺结核 DOTS 家庭督导员 

分 类 号：R521[医药卫生—内科学]