我国西南某大型三甲医院结核患者出院时疾病不确定感及其影响因素研究  

Study on the uncertainty in illness and its influencing factors in discharged patients with tuberculosis of a grade tertiary hospital in Southwest China

作　　者：刘祥敏[1] 何燕[1] 文艳[1] 向希[1] 王丹[1] 薛秒[1] LIU Xiang-min;HE Yan;WEN Yan;XIANG Xi;WANG Dan;XUE Miao(Respiratory Medicine Critical Care Department,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西医院呼吸与危重症医学科,四川成都610041

出　　处：《现代预防医学》2018年第16期2972-2975,共4页Modern Preventive Medicine

基　　金：四川省科技厅重点研发项目(项目编号:2018KZ0013)

摘　　要：目的了解西南某大型三甲医院结核住院患者出院时疾病不确定感情况,并分析其影响因素。方法采用横断面调查设计,应用一般资料调查表、疾病不确定感量表对2017年5月-10月四川大学华西医院结核病房当天出院的患者进行调查,采用多元线性回归方法分析影响结核患者出院时疾病不确定感的因素。结果 163例结核患者出院时疾病不确定感总分为(74.20±11.94)分,其中不确定性(46.94±9.33)分、复杂性(26.78±4.79)分。多元线性回归显示:影响因素有是否方便就医(β’=-0.469,95%CI=-14.136^-8.876)、是否为涂阳/复治耐药/合并其他传染病(β’=0.251,95%CI=3.407~8.279)、收入(β’=-0.274,95%CI=-4.198^-1.742)、年龄(β’=0.180,95%CI=0.048~0.185)、民族(藏)(β’=0.201,95%CI=3.151~9.720)、文化程度(β’=-0.126,95%CI=-2.145^-0.077)。结论该院结核患者出院时疾病不确定感处于中高水平,可能与基层防痨力量薄弱、患者自身病情复杂性、结核易患人群特殊性以及可获得的社会支持较低有关。结核患者出院时健康教育应注意针对性、个体化,方式多元化,充分利用互联网+平台为患者(尤其边远藏区)提供院外信息支持,以降低其疾病不确定感,减少复治及耐药的发生。Objective To explore the uncertainty in illness of discharged patients with tuberculosis and find out its influencing factors. Methods The patient＇s basic information questionnaire and the Mishel Uncertainty in Illness Scale（MUIS） were used to investigate in discharged patients with tuberculosis at a grade tertiary hospital in Chengdu from May to October in 2017.The data were analyzed through multiple linear regression analysis. Results The total score of 163 patients with tuberculosis of MUIS, ambiguity dimension, complexity dimension were 73.54 ±11.59,46.94 ±9.33 and 26.78 ±4.79,respectively. Multiple linear regression analysis showed that MUIS was affected by convenience for medical advice（β＇=-0.469, 95% CI =-14.136--8.876）, severity of illness（β＇=0.251, 95%CI=3.407-8.279）, income（β＇=-0.274, 95%CI=-4.198--1.742）, age（β＇=0.180,95%CI=0.048-0.185）, nation（β＇=0.201, 95%CI =3.151-9.720） and education level（β＇=-0.126,95% CI =-2.145--0.077）.Conclusion Patients with tuberculosis in the hospital has a high level of disease uncertainty when they left hospital,it may be related to imperfect network of primary anti-TB,infectivity, disease aggravation, less available social support. In order to decrease their uncertainty in illness,individualized and diversified health education as well as information support by internet should be provided to TB hospital patients.

关 键 词：结核患者 疾病不确定感 影响因素 

分 类 号：R195[医药卫生—卫生统计学]