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

Abstract:

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 (50.0%, 15/30). Additionally, the mortality rate (0) and recurrence rate (6.7%, 2/30) in the observation group were significantly lower than those in the control group (13.3%, 4/30, and 30.0%, 9/30, respectively). These differences were statistically significant (χ²=5.934, P=0.015; χ²=4.286, P=0.038; χ²=5.455, P=0.020). Conclusion: The integration of a continuity of care model into routine nursing care significantly enhances treatment adherence in TBM patients, improves self-efficacy, optimizes prognosis, and reduces the risks of disability and disease recurrence.

Key words: Mycobacterium tuberculosis, Meningitis, bacterial, Nursing care, Clinical nursing research, Continuity of care