医院-家庭-社区一体化管理策略对肺结核合并糖尿病患者消极情绪及自我护理能力的影响

doi:10.3760/cma.j.issn.1007-1245.2023.05.030

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (5): 723-728.DOI: 10.3760/cma.j.issn.1007-1245.2023.05.030

医院-家庭-社区一体化管理策略对肺结核合并糖尿病患者消极情绪及自我护理能力的影响

肖晶晶¹ 姚蕾² 张萍³

¹信阳市第五人民医院呼吸内科，信阳　464000；²信阳市第五人民医院外科，信阳　464000；³信阳市第五人民医院医保科，信阳　464000

收稿日期:2022-10-10 出版日期:2023-03-01 发布日期:2023-03-31
通讯作者: 肖晶晶，Email：Xjing896@163.com
基金资助:
2018年河南省医学科技攻关计划项目（201803146）

Influence of hospital-family-community integrated management strategy on negative emotions and self-care ability in patients with pulmonary tuberculosis complicated with diabetes

Xiao Jingjing¹, Yao Lei², Zhang Ping³

¹Department of Respiratory Medicine, Xinyang Fifth People's Hospital, Xinyang 464000, China; ²Surgery Department, Xinyang Fifth People's Hospital, Xinyang 464000, China; ³Department of Medical Insurance, Xinyang Fifth People's Hospital, Xinyang 464000, China

Received:2022-10-10 Online:2023-03-01 Published:2023-03-31
Contact: Xiao Jingjing, Email: Xjing896@163.com
Supported by:
Medical Science and Technology Project of Henan Province in 2018 (201803146)

摘要/Abstract

摘要：

目的　探究医院-家庭-社区一体化管理策略在肺结核合并糖尿病患者中的应用效果。方法　本研究为前瞻性研究。选取2020年1月至2022年1月信阳市第五人民医院收治的肺结核合并糖尿病患者130例，按照入院顺序分为两组，各65例。对照组男34例，女31例，年龄（53.61±6.28）岁，予以常规护理；观察组男33例，女32例，年龄（54.33±7.02）岁，予以常规护理联合医院-家庭-社区一体化护理。对比两组患者干预后病情相关指标，比较干预前后抑郁自评量表（SDS）、焦虑自评量表（SAS）、自我管理能力、一般自我效能量表（GSES）、生活质量综合评定问卷-74（GQOL-74）评分及护理满意度。统计学方法采用独立样本t检验、配对t检验、χ²检验。结果　干预后胸片检查显示病灶好转率观察组高于对照组［92.31%（60/65）比78.46%（51/65）］（χ²=4.993，P=0.026）；干预后观察组血糖正常率高于对照组［95.38%（62/65）比83.08%（54/65）］（χ²=5.123，P=0.024）；干预后观察组痰培养阳性率低于对照组［13.85%（9/65）比29.23%（19/65）］（χ²=4.552，P=0.033）；干预后观察组SDS、SAS评分分别为（32.45±5.17）分、（29.62±6.98）分，均低于对照组的（37.94±5.33）分、（33.94±5.94）分，差异均有统计学意义（t=5.961、3.800，均P<0.001）；干预后观察组自我管理能力、GSES、GQOL-74评分分别为（99.98±5.03）分、（32.69±4.25）分、（88.58±4.29）分、均高于对照组的（93.58±6.58）分、（27.68±4.38）分、（79.85±5.68）分，差异均有统计学意义（t=6.230、6.618、9.888，均P<0.001）；观察组护理总满意度高于对照组［98.46%（64/65）比81.69%（56/65）］（χ²=6.933，P=0.009）。结论　医院-家庭-社区一体化管理策略可增强肺结核合并糖尿病患者的自我管理能力与自我效能感，帮助其调节消极情绪，改善生活质量，促进病情恢复，进而提高满意度。

关键词:

糖尿病, 肺结核, 消极情绪, 自我护理能力, 医院-家庭-社区一体化管理策略

Abstract:

Objective　To explore the application effect of hospital-family-community integrated management strategy in pulmonary tuberculosis patients with diabetes. Methods　It was a prospective study. A total of 130 patients with pulmonary tuberculosis and diabetes admitted to Xinyang Fifth People's Hospital from January 2020 to January 2022 were selected. They were divided into two groups according to the order of admission: 65 cases in the control group and 65 cases in the observation group. In the control group, there were 34 males and 31 females, aged (53.61±6.28) years. In the observation group, there were 33 males and 32 females, aged (54.33±7.02) years. The control group was given routine nursing intervention, and the observation group was given routine nursing care combined with hospital-family-community integrated nursing intervention. The disease-related indicators after intervention, scores of Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), General Self-efficacy Scale (GSES), Generic Quality of Life Inventory 74 (GQOL-74), and self-management ability before and after intervention, and nursing satisfaction were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After intervention, the improvement rate of focus in the observation group was higher than that in the control group [92.31% (60/65) vs. 78.46% (51/65)] (χ²=4.993, P=0.026); the normal rate of blood glucose in the observation group was higher than that in the control group [95.38% (62/65) vs. 83.08% (54/65)] (χ²=5.123, P=0.024); the positive rate of sputum culture in the observation group was lower than that in the control group [13.85% (9/65) vs. 29.23% (19/65)] (χ²=4.552, P=0.033). After intervention, the SDS and SAS scores of the observation group were (32.45±5.17) points and (29.62±6.98) points, respectively, which were lower than those of the control group [(37.94±5.33) points and (33.94±5.94) points], with statistically significant differences (t=5.961 and 3.800; both P<0.001). After intervention, the scores of self-management ability, GSES, and GQOL-74 in the observation group were (99.98±5.03) points, (32.69±4.25) points, and (88.58±4.29) points, respectively, which were higher than those in the control group [(93.58±6.58) points, (27.68±4.38) points, and (79.85±5.68) points], with statistically significant differences (t=6.230, 6.618, and 9.888; all P<0.001). The nursing satisfaction of the observation group was higher than that of the control group [98.46% (64/65) vs. 81.69% (56/65)] (χ²=6.933, P=0.009). Conclusion　The hospital-family-community integrated management strategy can enhance the self-management ability and self-efficacy in patients with pulmonary tuberculosis complicated with diabetes, helps them adjust their negative emotions, improve their quality of life, promote the recovery of the disease, and then improve their satisfaction.

Key words:

Diabetes, Pulmonary tuberculosis, Negative emotions, Self-care ability, Hospital-family-community integrated management strategy

肖晶晶姚蕾张萍.

医院-家庭-社区一体化管理策略对肺结核合并糖尿病患者消极情绪及自我护理能力的影响 [J]. 国际医药卫生导报, 2023, 29(5): 723-728.

Xiao Jingjing, Yao Lei, Zhang Ping.

Influence of hospital-family-community integrated management strategy on negative emotions and self-care ability in patients with pulmonary tuberculosis complicated with diabetes [J]. International Medicine and Health Guidance News, 2023, 29(5): 723-728.

参考文献

[1] Armstrong LR, Kammerer JS, Haddad MB. Diabetes mellitus among adults with tuberculosis in the USA, 2010-2017[J]. BMJ Open Diabetes Res Care, 2020, 8(1): e001275. DOI: 10.1136/bmjdrc-2020-001275.
[2] Evangelista MDSN, Maia R, Toledo JP, et al. Tuberculosis associated with diabetes mellitus by age group in Brazil: a retrospective cohort study, 2007-2014[J]. Braz J Infect Dis, 2020, 24(2): 130-136. DOI: 10.1016/j.bjid.2020. 03.005.
[3] Al-Rifai RH, Pearson F, Critchley JA, et al. Association between diabetes mellitus and active tuberculosis: a systematic review and meta-analysis[J]. PLoS One, 2017, 12(11): e0187967. DOI:10.1371/journal.pone.0187967.
[4] 袁媛,司艳,丁晓彤. 医院社区家庭护理对乳腺癌根治术患者术后康复的影响[J]. 中国肿瘤临床与康复,2020,27(1):100-102. DOI:10.13455/j.cnki.cjcor.2020.01.29.
[5] 杨利娟,朱记芬,祝巾玉,等. 医院⁃社区⁃家庭一体化护理管理方案的构建与实施[J]. 护理研究,2020,34(3):519-521. DOI:10.12102/j.issn.1009-6493.2020.03.040.
[6] 蔡耀婷,方荣华. 骨质疏松症患者医院-社区-家庭一体化管理路径探究及对基层医疗的启示[J]. 中国全科医学,2021,24(15):1938-1942. DOI:10.12114/j.issn.1007-9572. 2021.00.431.
[7] 中华医学会结核病学分会. 肺结核诊断和治疗指南[J]. 中国实用乡村医生杂志,2013,20(2):7-11. DOI:10.3969/j.issn.1672-7185.2013.02.005.
[8] 袁刚,赵晋,郑冬,等. 抑郁自评量表和贝克抑郁量表区分抑郁症严重程度的准确度[J]. 神经疾病与精神卫生,2021,21(12):868-873. DOI:10.3969/j.issn.1009-6574.2021. 12.006.
[9] 白晶莹,李婷. 疼痛护理对混合痔患者术后疼痛焦虑自评量表评分的影响[J]. 山西医药杂志,2020,49(4):502-503. DOI:10.3969/j.issn.0253-9926.2020.04.058.
[10] 金玲玲,叶青,马雨杨,等. 社区2型糖尿病患者自我管理能力"三位一体"糖尿病精细化管理模式干预效果评价[J]. 中国公共卫生,2020,36(5):810-813. DOI:10.11847/zgggws1121368.
[11] 张驰,曾平,刘德平,等. 一般自我效能量表在医学研究生中的适用性评价与应用[J]. 中华医学教育探索杂志,2022,21(2):135-140. DOI:10.3760/cma.j.cn116021-20201215- 00750.
[12] 李小姣. 反馈式康复护理对卒中后偏瘫患者生活质量综合评定问卷-74评分的影响[J]. 山西医药杂志,2021,50(9):1579-1581. DOI:10.3969/j.issn.0253-9926.2021.09.071.
[13] Rodríguez-Herrera C, López-Jiménez JJ, Del Toro-Valero A, et al. The Newcastle satisfaction with nursing scales in a Mexican Oncology Hospital[J]. Afr Health Sci, 2021, 21(1): 60-66. DOI: 10.4314/ahs.v21i1.10.
[14] 徐静,罗萍,贺晓新. 肺结核合并糖尿病与单纯肺结核患者流行特征对比分析[J]. 中国防痨杂志,2022,44(5):494-499. DOI:10.19982/j.issn.1000-6621.20220047.
[15] 宋涛,梁志强,刘玉美,等. 专职健康教育护士在肺结核患者管理中的应用[J]. 国际医药卫生导报,2022,28(12):1755-1757. DOI:10.3760/cma.j.issn.1007-1245.2022. 12.029.
[16] Foe-Essomba JR, Kenmoe S, Tchatchouang S, et al. Diabetes mellitus and tuberculosis, a systematic review and meta-analysis with sensitivity analysis for studies comparable for confounders[J]. PLoS One, 2021, 16(12): e0261246. DOI:10.1371/journal.pone.0261246.
[17] 荣静,杨秀梅,张燕娟. "医院-社区-家庭"三元联动社会支持对乙肝肝硬化代偿期患者心理弹性及自我管理能力的影响[J]. 实用预防医学,2022,29(1):98-101. DOI:10.3969/j.issn.1006-3110.2022.01.025.
[18] 张华,罗燕,李雪芹,等. 医院社区一体化管理对慢性肾脏病患者疾病干预的影响分析[J]. 中国医药,2020,15(6):919-922. DOI:10.3760/j.issn.1673-4777.2020.06.028.
[19] 努尔曼·阿卜杜克力木,韩正风,马艳. 医院-社区-家庭一体化康复模式对老年衰弱综合征患者的影响[J]. 基础医学与临床,2022,42(4):640-645. DOI:10.3969/j.issn.1001- 6325.2022.04.015.
[20] 宋舒娟,周方园,刘建敏. 医院—社区—家庭一体化护理模式对肝癌介入治疗患者生活质量的影响[J]. 中国肿瘤临床与康复,2021,28(5):631-634. DOI:10.13455/j.cnki.cjcor. 2021.05.29.
[21] 夏章,姜莹莹,毛凡,等. 中国六省市糖尿病患者自我管理2年随访生存质量变化及其影响因素分析[J]. 中国公共卫生,2022,38(3):285-290. DOI:10.11847/zgggws1131688.
[22] 张艳萍,傅桂芬,黄彦飞,等. 医院-社区血糖云管理对老年糖尿病患者自我管理能力的影响[J]. 广西医学,2020,42(8):1052-1054. DOI:10.11675/j.issn.0253-4304.2020.08.32.
[23] 牛俊梅,李振魁,张边防,等. 糖尿病合并肺结核与单纯肺结核患者血清细胞因子水平、临床疗效和转归比较[J]. 热带医学杂志,2020,20(2):245-248. DOI:10.3969/j.issn.1672- 3619.2020.02.025.
[24] Silva DR, Muñoz-Torrico M, Duarte R, et al. Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs[J]. J Bras Pneumol, 2018, 44(2): 145-152. DOI:10.1590/s1806-37562017000000443.
[25] 宋文娟,张小冯,张艳君. 北京市高龄老年人的心理健康状况及其影响因素分析[J]. 中国医药导报,2021,18(2):44-47.
[26] 钟帅,王曙红,张鑫,等. 居家养老家庭照顾者心理健康分析及对策思考[J]. 中国临床保健杂志,2021,24(4):489-494. DOI:10.3969/J.issn.1672-6790.2021.04.014.
[27] 陈洁瑶,方亚,曾雁冰. 多元社会参与及家庭支持对中国老年人心理健康的影响研究[J]. 中国卫生政策研究,2021,14(10):45-51. DOI:10.3969/j.issn.1674-2982.2021. 10.007.
[28] Zurita-Cruz JN, Manuel-Apolinar L, Arellano-Flores ML, et al. Health and quality of life outcomes impairment of quality of life in type 2 diabetes mellitus: a cross-sectional study[J]. Health Qual Life Outcomes, 2018, 16(1):94. DOI:10.1186/s12955-018-0906-y.
[29] 邓辉,黎敏,王春霞,等. 社区-医院-家庭互动管理模式在社区老年人衰弱干预实践[J]. 护理学报,2020,27(15):21-24. DOI:10.16460/j.issn.1008-9969.2020.15.021.
[30] 周晓月,郑亚丽,周仙琴. 医院-社区-家庭一体化延续护理对精神分裂症患者防治和康复的影响[J]. 中国康复,2022,37(1):61-64. DOI:10.3870/zgkf.2022.01.014.
[31] 胡晓龙,陈婷婷,赵姣文,等. 社会组织介入严重精神障碍患者医院-社区-家庭一体化服务的探索[J]. 中国社会医学杂志,2020,37(5):534-537. DOI:10.3969/j.issn.1673-5625. 2020.05.022.

医院-家庭-社区一体化管理策略对肺结核合并糖尿病患者消极情绪及自我护理能力的影响

Influence of hospital-family-community integrated management strategy on negative emotions and self-care ability in patients with pulmonary tuberculosis complicated with diabetes

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