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

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