唐山市社区老年糖尿病并发肺结核患者健康素养水平与预后分析  

Relationship between health literacy and prognosis in elderly diabetic patients complicated with pulmonary tuberculosis in communities of Tangshan City

作　　者：吕婕[1] 郭霞 李球兵 赵雅玲[1] 王红阳 

机构地区：[1]唐山市人民医院,河北唐山063000 [2]华北理工大学附属医院

出　　处：《实用预防医学》2017年第2期129-133,共5页Practical Preventive Medicine

基　　金：河北省卫生厅一般项目(20150531)

摘　　要：目的研究社区老年糖尿病并发肺结核患者的健康素养水平与预后的关系,为社区的干预提供依据。方法应用两阶段整群系统抽样方法选择唐山市社区373例糖尿病并发肺结核患者为研究对象,评价患者的健康素养水平、康复依从性、社区服务利用情况、结核病灶及血糖控制情况等;采用χ~2检验和多因素logistic回归分析健康素养水平与预后的关系。结果基本健康素养组结核病灶控制总有效率82.7%,血糖控制良好率88.8%,显著高于低健康素养组(61.1%和66.3%),差异有统计学意义(P<0.05);logistic回归分析显示影响糖尿病并发肺结核患者预后的因素包括:健康素养、依从性、社区卫生服务利用情况、结核类型、血糖控制情况以及合并其他疾病等(OR=5.997、5.548、5.816、0.151、0.066、0.162,P<0.05);基本健康素养组在依从性行为包括吸烟、饮酒及饮食、用药、康复锻炼五方面优于低健康素养组,差异有统计学意义(P<0.05);基本健康素养组在社区卫生服务(免费健康教育和咨询、免费体检、免费流感疫苗接种、免费血压、血糖监测、生活方式及康复指导)的利用情况优于低健康素养组,差异有统计学意义(P<0.05)。结论唐山市社区糖尿病并发肺结核患者健康素养水平越高,其社区卫生服务利用情况越高、遵医行为越好,有利于提高预后效果。Objective To study the relationship between health literacy and prognosis in elderly diabetic patients complicated with pulmonary tuberculosis so as to provide evidence for the community intervention. Methods We selected 373 diabetic pa- tients complicated with pulmonary tuberculosis in communities of Tangshan City as the research objects using two-stage cluster ran- dom sampling method. The patients＇ health literacy level, rehabilitation compliance, utilization of community health services, con- dition of TB lesions and blood sugar control were evaluated. The relationship between health literacy and prognosis were analyzed by chi-square test and logistic regression analysis. Results The total efficacy of pulmonary tuberculosis control and blood sugar control were significantly higher in the basic health literacy group than in the low health literacy group （ 82.7% vs. 61.1% and 88.8% vs. 66.3% ） { P〈0.05 ）. Logistic regression analysis showed that the factors affecting the prognoses of diabetic patients com- plicated with pulmonary tuberculosis were health literacy, compliance, utilization of community health services, tuberculosis type, blood sugar control and complication with other diseases （ OR = 5.997, OR = 5.548, OR = 5.816, OR = O. 151, OR = 0. 066, OR = 0. 162, P〈0.05）. The compliance behavior { including smoking, drinking, diet, medication and rehabilitation exercise） and utili- zation of community health services { including free health education and counseling, free physical examination, free influenza vac- cination, free monitoring of blood pressure and blood glucose, lifestyle and rehabilitation guidance in basic health literacy group were significantly superior to those in low health literacy group （ P〈0.05 ）. Conclusions For elderly diabetic patients compli- cated with pulmonary tuberculosis in Tangshan City, the higher the health literacy level, the better the utilization of community health services and compliance behavior. Health literacy is advantageous to promoting prog

关 键 词：糖尿病 肺结核 健康素养 依从性 基本卫生服务 

分 类 号：R587.1[医药卫生—内分泌]