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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (6): 606-611.doi: 10.3969/j.issn.1000-6621.2021.06.015

• 论著 • 上一篇    下一篇


赵阿利, 袁荣, 罗卉(), 何小谋, 党丽云   

  1. 710100 西安市胸科医院
  • 收稿日期:2020-12-16 出版日期:2021-06-10 发布日期:2021-06-02
  • 通信作者: 罗卉

Analysis of the effects of patient-centered comprehensive supportive care service for MDR/RR-TB patients

ZHAO A-li, YUAN Rong, LUO Hui(), HE Xiao-mou, DANG Li-yun   

  1. Xi’an Chest Hospital, Xi’an 710100, China
  • Received:2020-12-16 Online:2021-06-10 Published:2021-06-02
  • Contact: LUO Hui


目的 评价以患者为中心的耐多药/利福平耐药结核病(MDR/RR-TB)患者关怀服务的实施效果。方法 以西安市胸科医院确诊的MDR/RR-TB患者作为研究对象。其中,2019年6—12月西安市胸科医院新确诊的所有MDR/RR-TB患者(182例)均采用患者关怀服务模式,纳入观察组进行分析。同时,回顾性分析2018年6—12月确诊的所有MDR/RR-TB患者(159例),作为对照组。对照组患者在住院期间给予常规的依从性评估、健康教育、心理支持及出院后电话回访;观察组患者在常规措施基础上,提供个体化的关怀服务,包括住院期间一对一咨询、社区转介和出院后的复诊提醒、随访咨询,以及小组活动、同伴支持等措施。比较两组患者纳入治疗率、随访12个月失访率和复诊率的差异。结果 观察组患者的纳入治疗率、12个月复诊率分别为92.9%(169/182)和92.6%(1308/1413),均明显高于对照组患者[分别为84.9%(135/159)和78.3%(930/1188)],差异均有统计学意义(χ2=5.547,P=0.019;χ2=109.689,P<0.01)。观察组随访12个月失访率为7.0%(11/157),明显低于对照组的32.3%(43/133),差异有统计学意义(χ2=30.474,P<0.01)。观察组和对照组分别有10例(10/11)和27例(62.8%,27/43)的失访发生在随访的前6个月。结论 以患者为中心的关怀服务有助于提高患者的纳入治疗率和治疗依从性,降低随访12个月失访率。

关键词: 结核,抗多种药物性, 患者关怀, 护理实践模式, 对比研究


Objective To analyze the implementation effectiveness of patient-centered comprehensive supportive care service for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) patients. Methods The MDR/RR-TB patients diagnosed in Xi ’an Chest Hospital were selected as the subjects. Among them, all newly diagnosed MDR/RR-TB patients from June to December 2019 (182 cases), who received the patient-care services, were enrolled as the intervention group for analysis. Meanwhile, all newly diagnosed MDR/RR-TB patients from June to December 2018 (159 cases) were enrolled as the control group. Patients in the control group were given regular compliance assessment, health education and psychological support during hospitalization and follow-up by telephone after discharge. On the basis of routine measures, patients in the intervention group were provided with individualized care services, including one-on-one consultation and community referral during hospitalization, and subsequent visit reminders, follow-up consultation, group activities and peer support, etc., after discharge. The differences of the treatment rate, the rate of loss to follow-up (LTFU) at the 12th month, and the rate of subsequent visits were compared between the two groups. Results The treatment rate and the 12-month follow-up rate of patients in the intervention group were 92.9% (169/182) and 92.6% (1308/1413) respectively, which were significantly higher than those in the control group (84.9% (135/159) and 78.3% (930/1188) respectively), and the differences were statistically significant (χ2=5.547, P=0.019; χ2=109.689, P<0.01). The LTFU rate at the 12th month of the control group was 7.0% (11/157), which was significantly lower than the control group (32.3%, 43/133). The difference was statistically significant (χ2=30.474, P<0.01). Ten cases (10/11) of the intervention group and 27 cases (62.8%, 27/43) of the control group were LTFU in the first 6 months. Conclusion Patient-centered supportive care services could help to improve the treatment rate and treatment adherence of the MDR/RR-TB patients, and reduce the rate of LTFU at the 12th month.

Key words: Tuberculosis,multidrug-resistant, Patient care, Nursing practice model, Comparative study