贵州省传染性肺结核集中住院治疗模式下患者管理质性研究  

A qualitative study of patient management under the centralized hospitalization model of infectious tuberculosis in Guizhou Province

作　　者：倪雪 李进岚 周建[2] 王秉萍 郭雪丽 马晓雪 陈慧娟 王芸 NI Xue;LI Jinlan;ZHOU Jian;WANG Bingping;GUO Xueli;MA Xiaoxue;CHEN Huijuan;WANG Yun(School of Public Health,Guizhou Medical University,Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guiyang,Guizhou 561113,China;不详)

机构地区：[1]贵州医科大学公共卫生与健康学院环境污染与疾病监控教育部重点实验室,贵州贵阳561113 [2]贵州省疾病预防控制中心

出　　处：《中国预防医学杂志》2024年第3期338-343,共6页Chinese Preventive Medicine

基　　金：贵州省卫生健康委科学技术基金项目(gzwkj2023-076);贵州省科技计划项目(ZK-2022-386)。

摘　　要：目的 了解贵州省传染期肺结核患者集中住院治疗模式下,结核患者住院管理现状及存在的主要问题。方法 2022年7-12月,选取在贵州省13家县级结核定点医院正在接受集中住院治疗的病原学阳性结核患者,医务人员进行一对一、半结构化深入访谈,同时组织集中住院治疗政策保障利益相关部门人员进行焦点小组讨论。使用NVIVO软件对数据进行转录和处理,采用Colaizzi七步分析法对资料进行分析。结果 共调查住院治疗的病原学阳性结核患者26例和医务人员13名,共焦点小组讨论5次。提炼传染期肺结核患者集中住院治疗的优势、实践的困难、开展传染性肺结核集中住院治疗的期望/建议3个部分,共17个一级主题,13个二级主题。结论 贵州省病原学阳性肺结核患者集中隔离治疗模式存在患者欠缺结核病防治知识、住院期间有负面情绪和经济压力、医疗机构设备和人员不足等问题。建议针对患方开展健康教育,提供心理健康支持并给予减免政策以降低其住院隔离治疗期间的经济负担;针对医疗机构,加大投入并引进新的诊断技术,以提高服务能力。Objective To investigate the current situation and major problems of inpatient management of tuberculosis patients under the centralized hospitalization of infectious tuberculosis patients model in Guizhou Province in China.Methods From July to December 2022,pathogen-positive tuberculosis patients who were receiving centralized hospitalization treatment in 13 county-level designated tuberculosis hospitals in Guizhou Province were selected for one-on-one semi-structured in-depth interviews by medical staff members.Focus group discussions were organized with personnel of relevant departments that were involved in ensuring the implementation of centralized hospitalization policy.Data were transcribed and processed using NVIVO software,and then analyzed using the Colaizzi's seven-step method.Results A total of 26 pathogen-positive tuberculosis patients receiving centralized hospitalization treatment were interviewed,and 13 medical staff members participated in 5 focus group discussions.Three main parts(the advantages of centralized hospitalization treatment for infectious tuberculosis patients,the difficulties in practice,and the expectations/suggestions for the implementation of centralized hospitalization treatment for infectious tuberculosis)were summarized,covering 17 primary themes and 13 secondary themes.Conclusions Some problems are identified in the centralized hospitalization treatment model for pathogen-positive tuberculosis patients in Guizhou Province,such as the lack of tuberculosis prevention and treatment knowledge among the patients,the presence of negative emotion and financial burden during hospitalization,and the shortage of medical equipment and staff in healthcare facilities,etc.We recommend that health education,mental health support,and remission policies be provided to alleviate patients'financial burden during hospitalization.Furthermore,investment should be increased for healthcare facilities to introduce new diagnostic technologies to improve their service capacity.

关 键 词：肺结核 集中隔离 患者管理 质性研究 住院意愿 

分 类 号：R446.5[医药卫生—诊断学]