耐多药肺结核患者依从性调查及干预研究

目的 了解影响耐多药结核病患者规律服药依从性的相关因素，探讨改进服药督导方法及措施。 方法采用自行设计的患者用药依从性问卷,对78例耐多药结核病患者的用药依从性进行干预调查，发出78份问卷，回收78份问卷，有效问卷78份。将患者按登记号随机分为对照组和实验组（各39例），实验组平均年龄为(34.6±14.5)岁，对照组平均年龄为(35.3±14.7)岁，对照组采取常规用药督导模式，实验组在常规用药督导基础上采取层级管理督导。 结果 实验组耐多药结核病患者的完全遵照医嘱（简称“遵医”）的例数为28例，高于对照组的19例；实验组的不遵医例数为4例，少于对照组的11例,两组总体的遵医程度差异有统计学意义（Z=－2.234，P<0.05）。 结论 针对患者不同社会情况以及在治疗期间出现的不良反应、心理状况等，制定不同的护理干预措施，可提高患者的规律服药依从性，从而提高耐多药患者的治愈率。

Investigation and intervention of treatment compliance of MDR-TB cases

Objective To understand the influencing factors of treatment compliance of multi-drug resistant tuberculosis（MDR-TB） patients,and to explore new measures in order to improve TB patients＇ treatment comp-liance.Methods Seventy-eight MDR-TB cases were interviewed by the self-designed questionnaire,78 questionnaires were distributed and 78 valid questionnaires were received.The study subjects were divided randomly into experimental group and control group with 39 patients in each group.The average ages were（34.6±14.5） years for experimental group and（35.3±14.7） years for control group.The routine supervision measure was adopted in control group,while the hierarchical supervision based on routine supervision was taken in experimental group.Results There were 28 MDR-TB cases taking anti-TB drugs according to the doctor＇s advice completely in experimental group,higher than that of the control group（19 cases）.Four cases in experimental group did not fulfill the doctor＇s instructions,which was less than that of the control group（11 cases）.The treatment compliance of experimental group was higher than control group（Z=-2.234,P〈0.05）.Conclusion Different nursing intervention mea-sures should be developed according to the patient＇s social condition and adverse reactions,so that to improve the treatment compliance of MDR-TB patients and increase the cure rate eventually.