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目的探讨医护一体化护理方式联合患者自我效能训练对复治肺结核患者焦虑抑郁及生存质量的影响。方法选择温州市中心医院2010年1月—2014年1月收治的复治肺结核患者120例,随机分为对照组和观察组,各60例。所有患者均采用标准化复治肺结核治疗方案,治疗时长为12个月。同时2组患者均给予医护一体化护理方式,观察组患者在此基础上实行自我效能训练。采用焦虑评分(SAS)量表及抑郁评分(SDS)量表对2组患者护理前后抑郁及焦虑状态进行评价,采用生存质量评估量表(WHOQOL-BREF)观察2组患者护理前后生存质量评分变化,结束治疗及护理后随访1年,观察2组患者再咳血情况、复发率。结果护理后,2组患者SAS及SDS评分较护理前均有所下降,且观察组患者SAS及SDS评分下降程度高于对照组,差异均具有统计学意义(P<0.05)。护理后,2组患者各维度评分较护理前均有所上升,且观察组患者上升程度高于对照组,差异均具有统计学意义(P<0.05),观察组再咳血例数、再咳血量以及一年复发率等均明显低于对照组,差异有统计学意义(P<0.05)。结论结合自我效能管理的患者在心理方面、生活质量方面及治疗依从性方面均较单纯给予医护一体化护理患者有显著改善,因此值得临床推广应用。
Objective To investigate the effect of integrated medical care and self-efficacy training on anxiety, depression and quality of life in patients with retreated pulmonary tuberculosis. Methods 120 patients with re-treatment of pulmonary tuberculosis admitted to Wenzhou Central Hospital from January 2010 to January 2014 were randomly divided into control group and observation group, with 60 cases in each group. All patients were treated with standardized re-treatment of tuberculosis for a duration of 12 months. At the same time, two groups of patients were given medical care integrated nursing, observation group patients on the basis of self-efficacy training. The anxiety score (SAS) scale and depression scale (SDS) scale were used to evaluate the depression and anxiety before and after the nursing care. The changes of the quality of life before and after treatment were observed by WHOQOL-BREF , After the end of treatment and nursing follow-up of 1 year, observed two groups of patients with cough, recurrence rate. Results After nursing, the scores of SAS and SDS decreased in both groups before treatment, and the scores of SAS and SDS in observation group were lower than those in control group (P <0.05). After nursing, the score of each dimension of the two groups increased compared with that before nursing, and the rising degree of the observation group was higher than that of the control group, the difference was statistically significant (P <0.05) The blood volume and year recurrence rate were significantly lower than the control group, the difference was statistically significant (P <0.05). Conclusion Patients with self-efficacy management have significantly improved psychologically, quality of life and treatment compliance compared with purely nursing-care patients. Therefore, it is worthy of clinical application.