全程健康教育對耐多藥肺結核患者的心理情緒及治療依從性的影響

陳玉梅　廖雅怡　黃亞玲

摘 要：目的 分析全程健康教育對耐多藥肺結核患者的心理情緒及治療依從性的影響。方法 選擇2015年6月～2017年7月于我院進行治療的耐多藥肺結核疾病患者88例作為研究對象，隨機分為觀察組與對照組。對照組予以常規護理，觀察組在此基礎上進行全程健康教育護理。對比兩組患者焦慮、抑郁程度，中斷治療率、按醫囑服藥及定期復查情況。結果 觀察組患者SAS、SDS評分分別為（53.62±5.73）分和（55.63±6.02）分，對照組SAS、SDS評分分別為（65.28±5.91）分和（67.18±6.19）分，組間對比，差異有統計學意義（P<0.05）；觀察組患者按醫囑用藥、定期檢查及中斷治療率評分均高于對照組，差異有統計學意義（P<0.05）。結論 全程健康教育可有效緩解耐多藥肺結核患者焦慮、抑郁情緒，同時使患者在治療過程中持有較強的依從性。

關鍵詞：全程健康教育；耐多藥肺結核；心理情緒；依從性

中圖分類號：R473.5 文獻標識碼：A DOI：10.3969/j.issn.1006-1959.2018.22.054

文章編號：1006-1959（2018）22-0178-03

Effect of Whole-course Health Education on Psychological Emotion and Treatment Compliance of Patients with Multidrug-resistant Pulmonary Tuberculosis

CHEN Yu-mei，LIAO Ya-yi，HUANG Ya-ling，WEI Yan-fang，KUANG Hao-bin，TAN Xiao-yan，XIE Yu-hong

（Department of Tuberculosis，Guangzhou Chest Hospital，Guangzhou 510095，Guangdong，China）

Abstract：Objective To analyze the effects of whole-course health education on psychological emotion and treatment compliance in patients with multidrug-resistant pulmonary tuberculosis. Methods 88 patients with multidrug-resistant tuberculosis disease who were treated in our hospital from June 2015 to July 2017 were randomly divided into observation group and control group. The control group received routine care， and the observation group conducted full-course health education and nursing on this basis. The anxiety and depression of the two groups were compared， the treatment rate was interrupted， medication was taken according to doctor's advice， and regular review was performed. Results The SAS and SDS scores of the observation group were （53.62±5.73） and （55.63±6.02）， respectively. The SAS and SDS scores of the control group were （65.28±5.91） and （67.18±6.19）， respectively.There was a statistically significant difference between the groups （P<0.05）. The patients in the observation group were higher than the control group according to the doctor's prescription， regular examination and interruption treatment rate， and the difference was statistically significant （P<0.05）. Conclusion The whole process of health education can effectively alleviate the anxiety and depression of patients with multidrug-resistant tuberculosis， and at the same time make patients have strong compliance during the treatment.

Key words：Whole-course health education；Multidrug-resistant tuberculosis；Psychological emotion； Compliance

耐多藥肺結核（MDR-TB）主要通過呼吸道傳播，發病原因主要包括治療方案不合理，如藥物聯合應用的不合理、不恰當、用藥劑量不足、服藥方式不當等[1]；除此之外對結核病控制措施薄弱也是MDR-TB發生的主要因素[2]。李玉華[3]等指出臨床中收治的MDR-TB患者均具有病程長、治療費用高、治愈率低的特點， MDR-TB的發生對患者生活質量及身心健康均有較大程度影響[4]。臨床中針對MDR-TB患者及早發現，并制定相應方案進行治療，通常均能得到有效緩解。但大部分患者因對疾病的認知存在不足、且對治療的存在恐懼心理導致依從性較差，臨床中因失去信心而終止治療的案例屢見不鮮[5]。有學者在研究中指出，采用針對性護理方式輔助治療可有效提高患者依從性，改善預后[6]。故本次研究采用全程健康教育模式對耐多藥肺結核患者進行護理，觀察其對患者心理情緒及治療依從性的影響，現報告如下。……