健康信念模式下家属协同护理模式在初治涂阳肺结核患者自我管理中的应用效果  

Effect of family collaborative care model in self-management of new smear-positive tuberculosis patients under the health belief model collaborative

作　　者：徐良润 杨明莹[2] 郭映武 王赟 徐晶晶 侯菊艳 马云红 Xu Liangrun;Yang Mingying;Guo Yingwu;Wang Yun;Xu Jingjing;Hou Juyan;Ma Yunhong(DepartmentⅡof Internal Medicine,Kunming Third People’s Hospital,Kunming 650041,China;Department of Nursing,Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China;Disease Control Office,Kunming Third People’s Hospital,Kunming 650041,China;Department of Nursing,Kunming Third People’s Hospital,Kunming 650041,China;Department of Intensive Care Medicine,Kunming Third People’s Hospital,Kunming 650041,China)

机构地区：[1]昆明市第三人民医院内二科,昆明650041 [2]昆明医科大学第二附属医院护理部,昆明650101 [3]昆明市第三人民医院疾控办,昆明650041 [4]昆明市第三人民医院护理部,昆明650041 [5]昆明市第三人民医院重症医学科,昆明650041

出　　处：《中国防痨杂志》2025年第2期210-217,共8页Chinese Journal of Antituberculosis

基　　金：昆明市卫生人才培养项目[2023-SW(技)-20];中国公共卫生联盟(第二批)。

摘　　要：目的:探讨健康信念模式下家属协同教育在初治涂阳肺结核患者自我管理中的应用效果。方法:采用目的抽样法选取2022年12月至2023年3月昆明市第三人民医院结核病科一病区初治涂阳肺结核患者及其家属各67例/名为对照组(采用常规健康教育方式),以结核病科三病区初治涂阳肺结核患者及其家属各69例/名为观察组(采用健康信念模式下家属协同健康教育),排除治疗第2个月末时两组患者各脱组1例后(家属也随即脱组),两组患者及其家属数分别为66例(名)和68例(名)。分析不同健康教育干预后两组患者及其家属对结核病相关知识掌握情况,以及抗结核治疗后的第2、5、6个月末患者服药依从性量表(MMAS-8)得分、焦虑自评量表(SAS)得分、抑郁自评量表(SDS)得分、痰培养和痰涂片结果。结果:干预后,对照组患者和家属结核病相关知识掌握情况得分[分别为(6.00±1.30)分和(5.93±0.65)分]均明显低于观察组患者和家属[分别为(6.77±1.23)分和(7.01±0.98)分],差异均有统计学意义(t=-3.549,P<0.001;t=-7.549,P<0.001)。抗结核治疗后的第2、5、6个月末,观察组患者的SAS和SDS得分[分别为(39.61±9.09)分、(36.97±9.63)分、(34.18±7.53)分和(46.21±12.97)分、(44.40±11.93)分、(44.16±9.01)分]均明显低于对照组[分别为(42.73±8.44)分、(40.29±8.55)分、(38.17±8.95)分和(50.75±12.63)分、(49.94±11.85)分、(48.52±13.30)分],MMAS-8得分[(6.97±0.98)分、(7.02±0.86)分、(7.31±0.69)分]均明显高于对照组[(6.08±0.81)分、(6.63±0.89)分、(6.77±0.95)分],差异均有统计学意义(t=2.051,P=0.042;t=2.099,P=0.038;t=2.792,P=0.006;t=2.045,P=0.043;t=2.689,P=0.008;t=2.222,P=0.028;t=-5.737,P<0.001;t=-2.580,P=0.011;t=-3.755,P<0.001)。结论:健康信念模式下家属协同健康教育可提高初治涂阳肺结核患者及其家属肺结核相关知识认知水平和患者服药依从性水平,改善患者不良心理状态,值得在临床肺结核患Objective:To investigate the effect of family collaborative care model in self-management of new smear-positive tuberculosis patients under the health belief model.Methods:Purposive sampling method was based to select the patients.Sixty-seven patients and their families were selected from December 2022 to March 2023 in the first ward of the tuberculosis department of the Third People’s Hospital of Kunming as the control group(received conventional health education approach),and 69 patients and their families in the third ward of the tuberculosis department were selected as the observation group(received family collaborative health education based on the health belief model).After excluding one patient(the families also removed immediately)from each group after two months of treatment,the enrolled patients and their families in the control group and the observation group were 66 and 68,respectively.Tuberculosis related knowledge among the two groups of patients and their families were analyzed after different health education interventions.The medication adherence(MMAS-8)scale scores,self-assessment of anxiety(SAS)scale scores,self-assessment of depression(SDS)scale scores,and the results of sputum culture and smear microscopy at the end of the 2nd,5th,and 6th months of anti-tuberculosis treatment were also analyzed.Results:After implementation of different interventions,the scores of tuberculosis-related knowledge among patients and family members in the control group(6.00±1.30 and 5.93±0.65)were lower than those of patients and family members in the observation group(6.77±1.23 and 7.01±0.98,respectively),with statistically significant differences(t=-3.549,P<0.001;t=-7.549,P<0.001).At the end of the 2nd,5th,and 6th months of anti-tuberculosis treatment,the SAS and SDS scores of the observation group(39.61±9.09,36.97±9.63,34.18±7.53,and 46.21±12.97,44.40±11.93,and 44.16±9.01,respectively)were significantly lower than those of the control group(42.73±8.44,40.29±8.55,38.17±8.95 and 50.75±12.63,49.94�

关 键 词：结核 肺 自我护理 病例管理 健康教育 护理方法学研究 

分 类 号：R52[医药卫生—内科学] G478.2[医药卫生—临床医学]