以街道社区卫生服务中心为主导的肺结核患者督导管理模式效果研究
|
摘要
目的探讨以街道社区卫生服务中心为主导的肺结核患者督导管理模式所取得的效果。方法选择2016年10月-2018年3月在林校社区完成服药管理的肺结核患者87例为病例组,选择未施行街道社区卫生服务中心督导管理之前(2015年1月-2016年9月之间)住址归属于林校社区管理的完成服药管理的肺结核患者90例为对照组,对照组患者由区级结核病预防控制中心相关人员完成督导过程,病例组患者由社区卫生服务中心人员完成督导过程,对比干预的效果。结果 2组患者的不良反应及时发现率数据差异无统计学意义(χ~2=1.901,P>0.05),病例组患者的首次面访率、周访合格率、规律服药率、治愈率均高于对照组患者,数据差异均具有统计学意义(χ~2=10.735、12.679、12.670、7.563,P>0.05),病例组患者的治疗依从性和管理满意度优于对照组患者,数据差异具有统计学意义(z=-9.077,-7.553,P<0.05),每名结核病管理医务人员每周管理每名患者的平均时间在不同时间点的数据差异具有统计学意义(F=84.588,P<0.05),每名结核病管理医务人员每周管理每名患者的平均时间逐渐上升(rs=0.783,P<0.05)。结论以街道社区卫生服务中心为主导的肺结核患者督导管理模式可以提升管理效果,但是应注意医生的人力消耗在不断增加的情况,并以更加科学的方式对该种模式进行管理。
Objective The aim of this study was to explore the effectiveness of the supervision and management model for tuberculosis patients led by street community health service centers. Methods 87 cases of tuberculosis patients were selected from October 2016 to March 2018 in the community of forest school. And 90 cases of tuberculosis patients who had not implemented the supervision and management of the community health service center(between January 2015 and September2016) belonging to the community management of the forest community were selected as the control group. The patients in the control group completed the process of supervision by the people related to the district level tuberculosis control, and the patients in the case group completed the supervision process by the community health service center. The effects of the intervention were compared. Results The two groups of patients had no significant difference in the rate of adverse reactions and timely detection(χ~2=1.901, P>0.05). The rate of first visit, the rate of weekly visit, the rate of regular medication and the cure rate were higher in the intervention group than those in the control group, and the difference of data was statistically significant(χ~2=10.735, 12.679, 12.670, 7.563, P>0.05). The compliance and management satisfaction of patients in the case group were better than those in the control group, and the difference was statistically significant(z=-9.077,-7.553, P<0.05).The average time for each patient to manage per week at different time points was statistically significant(F=84.588, P<0.05).The average time of weekly management of each patient was increased gradually(rs=0.783, P <0.05). Conclusion The management model of tuberculosis patients led by street community health service center can improve the management effect.However, attention should be paid to the increasing need of doctors and the management of the model in a more scientific way.
Objective The aim of this study was to explore the effectiveness of the supervision and management model for tuberculosis patients led by street community health service centers. Methods 87 cases of tuberculosis patients were selected from October 2016 to March 2018 in the community of forest school. And 90 cases of tuberculosis patients who had not implemented the supervision and management of the community health service center(between January 2015 and September2016) belonging to the community management of the forest community were selected as the control group. The patients in the control group completed the process of supervision by the people related to the district level tuberculosis control, and the patients in the case group completed the supervision process by the community health service center. The effects of the intervention were compared. Results The two groups of patients had no significant difference in the rate of adverse reactions and timely detection(χ~2=1.901, P>0.05). The rate of first visit, the rate of weekly visit, the rate of regular medication and the cure rate were higher in the intervention group than those in the control group, and the difference of data was statistically significant(χ~2=10.735, 12.679, 12.670, 7.563, P>0.05). The compliance and management satisfaction of patients in the case group were better than those in the control group, and the difference was statistically significant(z=-9.077,-7.553, P<0.05).The average time for each patient to manage per week at different time points was statistically significant(F=84.588, P<0.05).The average time of weekly management of each patient was increased gradually(rs=0.783, P <0.05). Conclusion The management model of tuberculosis patients led by street community health service center can improve the management effect.However, attention should be paid to the increasing need of doctors and the management of the model in a more scientific way.
引文
[1]顾维方.肺结核病实行家庭(社区)短程督导疗效评价[J].疾病控制杂志,2005,9(1):89-89.
[2]张合英.边远山区新发肺结核患者采用家庭成员督导化疗依从性的观察[J].职业与健康,2010,26(5):523-525.
[3]王飞,陈彬,周琳,等.耐多药肺结核患者抗结核药物所致不良反应发生情况[J].中华传染病杂志,2017,35(2):83-87.
[4]熊先明,梁亚君,柯静,等.两种氟喹诺酮类抗生素辅助利福布汀治疗MDR-TB临床对比研究[J].河北医药,2017,39(6):883-885.
[5]代晓琦,阮云洲,李仁忠,等."医防合作"模式下实施DOT对耐多药肺结核患者不同治疗转归的分析[J].中国防痨杂志,2016,38(11):929-933.
[6]蔡纪明,陈贤义.中国结核病控制工作典范--世界银行贷款传染病与地方病控制项目结核病控制部分终期评价报告[M].北京:人民卫生出版社,2003:18.
[7]管红云,谭卫国,杨应周,等.基于深圳市电子网络督导管理系统的肺结核患者管理治疗情况分析[J].中国防痨杂志,2017,39(7):702-707.
[8]李玲,姚嵩,邹铮,等.全球基金结核病项目安徽省试点耐多药结核病综合防治效果分析[J].中国防痨杂志,2017,39(7):728-731.
[9]中华人民共和国卫生部疾病预防控制司.关于开展《全国结核病防治规划(2001-2010年)》终期评估的通知[EB/OL].[2018-12-06].http://www.nhfpc.gov.cn/jkj/s3589/201009/946689dd09924a509b0c6f9f86169548.shtml.
[10]周俏梅,杜永杰.强化健康教育干预在流动人口肺结核患者中的应用效果观察[J].护理与康复,2015,14(2):185-188.
[11]王宇.耐多药肺结核防治管理工作方案[M].北京:军事医学科学出版社,2012:16-17.
[12] Person AK, Blain ML, Jiang H, et al. Text messaging for enhance-ment of testing and treatment for tuberculosis, human immunodefi-ciency virus, and syphilis:a survey of attitudes toward cellularphones and healthcare[J]. Telemedicine Journal and E-Health:theOfficial Journal of the American Telemedicine Association, 2011, 17(3):189-195.
[13] Muture BN, Keraka MN, Kimuu PK, et al. Factors associated withdefault from treatment among tuberculosis patients in Nairobiprovince, Kenya:a case control study[J]. BMC Public Health, 2011,11:696.
[14]陈曦,贺晓新,高志东,等.北京市区(县)社区结核病防治医务人员工作现状调查结果评价[J].中国防痨杂志,2015,37(2):183-188.
[15]王黎霞,成诗明,陈明亭,等.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
[2]张合英.边远山区新发肺结核患者采用家庭成员督导化疗依从性的观察[J].职业与健康,2010,26(5):523-525.
[3]王飞,陈彬,周琳,等.耐多药肺结核患者抗结核药物所致不良反应发生情况[J].中华传染病杂志,2017,35(2):83-87.
[4]熊先明,梁亚君,柯静,等.两种氟喹诺酮类抗生素辅助利福布汀治疗MDR-TB临床对比研究[J].河北医药,2017,39(6):883-885.
[5]代晓琦,阮云洲,李仁忠,等."医防合作"模式下实施DOT对耐多药肺结核患者不同治疗转归的分析[J].中国防痨杂志,2016,38(11):929-933.
[6]蔡纪明,陈贤义.中国结核病控制工作典范--世界银行贷款传染病与地方病控制项目结核病控制部分终期评价报告[M].北京:人民卫生出版社,2003:18.
[7]管红云,谭卫国,杨应周,等.基于深圳市电子网络督导管理系统的肺结核患者管理治疗情况分析[J].中国防痨杂志,2017,39(7):702-707.
[8]李玲,姚嵩,邹铮,等.全球基金结核病项目安徽省试点耐多药结核病综合防治效果分析[J].中国防痨杂志,2017,39(7):728-731.
[9]中华人民共和国卫生部疾病预防控制司.关于开展《全国结核病防治规划(2001-2010年)》终期评估的通知[EB/OL].[2018-12-06].http://www.nhfpc.gov.cn/jkj/s3589/201009/946689dd09924a509b0c6f9f86169548.shtml.
[10]周俏梅,杜永杰.强化健康教育干预在流动人口肺结核患者中的应用效果观察[J].护理与康复,2015,14(2):185-188.
[11]王宇.耐多药肺结核防治管理工作方案[M].北京:军事医学科学出版社,2012:16-17.
[12] Person AK, Blain ML, Jiang H, et al. Text messaging for enhance-ment of testing and treatment for tuberculosis, human immunodefi-ciency virus, and syphilis:a survey of attitudes toward cellularphones and healthcare[J]. Telemedicine Journal and E-Health:theOfficial Journal of the American Telemedicine Association, 2011, 17(3):189-195.
[13] Muture BN, Keraka MN, Kimuu PK, et al. Factors associated withdefault from treatment among tuberculosis patients in Nairobiprovince, Kenya:a case control study[J]. BMC Public Health, 2011,11:696.
[14]陈曦,贺晓新,高志东,等.北京市区(县)社区结核病防治医务人员工作现状调查结果评价[J].中国防痨杂志,2015,37(2):183-188.
[15]王黎霞,成诗明,陈明亭,等.2010年全国第五次结核病流行病学抽样调查报告[J].中国防痨杂志,2012,34(8):485-508.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |