Abstract:

Objective　To explore the intervention effect of regular follow-up on patients with multidrug-resistant tuberculosis (MDR-TB). Methods　One hundred patients with MDR-TB treated at Jiangxi Chest Hospital from January 2023 to March 2024 were selected for the prospective study, and were divided into a control group and an observation group by the random number table method, with 50 cases in each group. There were 38 males and 12 females in the control group; they were (46.18±12.02) years old. There were 38 males and 12 females in the observation group; they were (42.32±13.22) years old. The control group received routine intervention, while the observation group received regular follow-up after discharge and routine intervention. The medication adherence, follow-up adherence, treatment outcomes, self-care abilities [Exercise of Self-care Agency Scale (ESCA)], and quality of life [Generic Quality of Life Inventory (GQOLI-74)] were compared between the two groups. The measurement data were compared by the t test, the count data by the χ² test, and ranked data by the Mann-Whitney U test. Results　The medication adherence and follow-up adherence in the observation group were better than those in the control group (Z=2.591 and 2.321; P=0.010 and 0.020). The treatment success rate in the observation group was higher than that in the control group [84.00% vs. 66.00%; χ²=4.320; P=0.038]. After the intervention, the scores of self-care responsibility, self-care skills, self-concept, health knowledge, psychological function, social function, material living status, and physical function in the observation group were higher than than those in the control group (20.18±2.08 vs. 18.54±2.96, 36.32±4.51 vs. 32.24±3.62, 25.64±3.22 vs. 20.48±2.65, 53.24±5.81 vs. 45.28±5.08, 85.24±4.21 vs. 72.54±3.52, 84.24±5.22 vs. 78.54±4.65, 88.54±5.88 vs. 82.24±4.66, and 86.64±4.58 vs. 80.64±4.11), with statistical differences (all P<0.05). Conclusion　Regular follow-up intervention for patients with MDR-TB can improve their medication and follow-up adherence, self-care ability, and quality of life, and increase the treatment success rate.

Key words:

Multidrug resistant tuberculosis, Regular follow-up, Medication adherence, Self-care ability, Quality of life

摘要：

目的　探讨定期随访对耐多药结核病（MDR-TB）患者干预效果。方法　以前瞻性研究法，选取江西省胸科医院2023年1月至2024年3月收治的MDR-TB患者100例，按随机数表法分为两组，各50例。对照组男38例、女12例，年龄（46.18±12.02）岁，予常规干预；观察组男38例、女12例，年龄（42.32±13.22）岁，基于常规干预出院后予定期随访。对比两组用药依从性、复诊依从性、治疗转归情况、自我护理能力［自我护理能力量表（ESCA）］及生存质量［生活质量综合评定问卷（GQOLI-74）］。计量资料用t检验；计数资料用χ²检验；等级资料经Mann-Whitney U检验。结果　观察组用药依从性、复诊依从性较对照组优（Z=2.591、2.321，P=0.010、0.020）；观察组治疗成功率（84.00%）较对照组（66.00%）高（χ²=4.320，P=0.038）。干预后，观察组自护责任感［（20.18±2.08）分］、自护技能［（36.32±4.51）分］、自我概念［（25.64±3.22）分］、健康知识水平 ［（53.24±5.81）分］及心理功能［（85.24±4.21）分］、社会功能［（84.24±5.22）分］、物质生活状态［（88.54±5.88）分］、躯体功能评分［（86.64±4.58）分］均高于对照组［（18.54±2.96）分、（32.24±3.62）分、（20.48±2.65）分、（45.28±5.08）分、（72.54±3.52）分、（78.54±4.65）分、（82.24±4.66）分、（80.64±4.11）分］，差异均有统计学意义（均P<0.05）。结论　MDR-TB患者采用定期随访干预可提高用药与复诊依从性，提升治疗成功率，且可改善自我护理能力及生存质量。

关键词:

耐多药结核病, 定期随访, 用药依从性, 自我护理能力, 生存质量