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

Abstract:

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±11.85, 48.52±13.30 points, respectively). The MMAS-8 medication adherence scale scores of the observation group (6.97±0.98, 7.02±0.86, 7.31±0.69) were higher than those of the observation group (6.08±0.81, 6.63±0.89, 6.77±0.95), and the differences were statistically significant (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). Conclusion: Family collaborative care model under the health belief model can improve the tuberculosis-related knowledge among new smear-positive pulmonary tuberculosis patients and their family members, the patients’ medication adherence, and the patients’ adverse psychological state. It is worthy of being promoted in the tuberculosis patients management.

Key words: Tuberculosis, pulmonary, Self care, Case management, Health education, Nursing methodology research