延续性护理路径在结核性脑膜炎患者中的应用效果分析  

Effectiveness of a continuity of care model in patients with tuberculous meningitis

作　　者：郝明晓 米洁 许宗仪[1] Hao Mingxiao;Mi Jie;Xu Zongyi(Emergency Department,The Eighth Medical Center,General Hospital of the Chinese People’s Liberation Army,Beijing 100091,China;Institute of Tuberculosis Research,Senior Department of Tuberculosis,The Eighth Medical Center,General Hospital of the Chinese People’s Liberation Army,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心急诊医学科,北京100091 [2]解放军总医院第八医学中心结核病医学部研究所,北京100091

出　　处：《中国防痨杂志》2025年第4期477-481,共5页Chinese Journal of Antituberculosis

摘　　要：目的:分析对结核性脑膜炎(tuberculous meningitis,TBM)患者开展延续性护理路径的效果。方法:选取2015年4月至2022年10月解放军总医院第八医学中心收治的60例TBM患者为研究对象,其中2015年4月至2018年12月收治的30例TBM患者为对照组,2019年1月至2022年10月收治的30例TBM患者为观察组。对照组采用常规护理方式;观察组采取常规护理协同延续性护理路径干预。分别进行干预前后两组研究对象的生活质量和预后指标对比,以及干预前和干预后1、3、6、12个月的治疗依从性和自我效能水平对比。结果:观察组在进行延续性护理干预后的1、3、6、12个月的依从性评分值分别为75.24±4.02、80.36±4.45、86.74±5.62、90.61±6.02,均明显高于对照组(分值分别为67.00±4.58、73.99±4.70、78.10±5.50、80.55±5.98),差异均有统计学意义(t=7.406,P=0.000;t=5.391,P=0.000;t=6.018,P=0.000;t=6.494,P=0.000)。观察组干预后1、3、6、12个月的自我效能感量表评分值分别为24.82±3.98、26.56±4.02、29.44±3.45、33.21±3.77,均明显高于对照组(22.02±3.32、22.01±3.69、25.17±3.51、26.38±3.46),差异均有统计学意义(t=2.959,P=0.004;t=4.567,P=0.000;t=4.752,P=0.000;t=7.311,P=0.000)。观察组干预后生活质量评分也均高于对照组。观察组预后良好率(80.0%,24/30)明显高于对照组(50.0%,15/30);而死亡率和复发率[分别为0和6.7%(2/30)]均明显低于对照组[分别为13.3%(4/30)和30.0%(9/30)],差异均有统计学意义(χ^(2)=5.934,P=0.015;χ^(2)=4.286,P=0.038;χ^(2)=5.455,P=0.020)。结论:常规护理协同延续性护理路径干预,可以明显提高TBM患者的治疗依从性,提升其自我效能,改善预后,避免残疾及复发情况发生。Objective:To evaluate the effectiveness of a continuity of care model in managing patients with tuberculous meningitis(TBM).Methods:A total of 60 patients diagnosed with TBM and admitted to The Eighth Medical Center of the General Hospital of the Chinese People’s Liberation Army between April 2015 and October 2022 were included in the study.Among them,30 patients admitted between April 2015 and December 2018 were assigned to the control group,while 30 patients admitted between January 2019 and October 2022 comprised the observation group.The control group received routine nursing care,whereas the observation group underwent an integrated nursing intervention combining routine nursing care with a continuity of care model.The quality of life and prognostic outcomes of both groups were assessed before and after the intervention,along with treatment adherence and self-efficacy levels measured at 1,3,6,and 12 months post-intervention.Results:The treatment adherence scores in the observation group at 1,3,6,and 12 months following the continuity of care model intervention were 75.24±4.02,80.36±4.45,86.74±5.62,and 90.61±6.02,respectively,which were significantly higher than those in the control group(67.00±4.58,73.99±4.70,78.10±5.50,and 80.55±5.98,respectively).The differences were statistically significant(t=7.406,P=0.000;t=5.391,P=0.000;t=6.018,P=0.000;t=6.494,P=0.000).Similarly,self-efficacy scores in the observation group at 1,3,6,and 12 months post-intervention were 24.82±3.98,26.56±4.02,29.44±3.45,and 33.21±3.77,respectively,all of which were significantly higher than those in the control group(22.02±3.32,22.01±3.69,25.17±3.51,and 26.38±3.46,respectively).These differences were also statistically significant(t=2.959,P=0.004;t=4.567,P=0.000;t=4.752,P=0.000;t=7.311,P=0.000).Post-intervention quality of life scores were higher in the observation group compared to the control group.The favorable prognosis rate in the observation group(80.0%,24/30)was significantly higher than that in the control group

关 键 词：分枝杆菌 结核 脑膜炎 细菌性 护理 临床护理研究 延续护理 

分 类 号：R529.3[医药卫生—内科学] R47[医药卫生—临床医学]