涂阳肺结核患者住院隔离治疗意愿及影响因素研究

目的了解涂阳肺结核患者的住院隔离治疗意愿及其不愿住院隔离治疗的原因,为有效实施传染期肺结核患者的隔离工作提供科学依据。方法对2016年10月至2017年8月期间在深圳市宝安区慢性病防治院结核病防治科就诊的涂阳肺结核患者进行问卷调查。结果被调查的312名涂阳肺结核患者中,不愿住院隔离治疗的患者比例高达96.47%(301/312)。单因素分析发现,25~45岁、不患有其他疾病的患者住院隔离治疗意愿更低。住院不方便(79.07%)是患者不愿住院隔离治疗的首要原因;另外,有患者出于工作(42.52%)、家庭(36.54%)、住院费用过高(35.88%)以及自认症状较轻(15.61%)等原因而不愿进行住院隔离治疗。结论涂阳肺结核患者的住院隔离治疗意愿较低,仅依靠费用减免等支持性政策难以从根本上解决传染性结核病患者的管理问题。应当积极探索更有效的方法促进涂阳肺结核患者住院隔离治疗或其他适宜有效的患者隔离模式。

Study on intention and influencing factors of hospital isolation treatment for smear-positive patients

Objective To understand the intention of smear positive pulmonary tuberculosis patients to be hospitalized for isolation treatment and the reasons for their unwillingness to be hospitalized for isolation treatment,so as to provide scientific reference for the effective implementation of isolation work of tuberculosis patients in the infectious period.Methods A questionnaire survey was conducted among smear positive TB patients who visited the TB Department of Shenzhen Bao′an District chronic disease prevention and control hospital from October 2016 to August 2017.Results Among 312 smear positive TB patients,the proportion of those who did not wish to be hospitalized and treated in isolation was as high as 96.47%(301/312).Univariate analysis had shown that patients aged 25-45 and those who did not have other diseases were less willing to be hospitalized for isolation treatment.The inconvenient of hospitalization(79.07%)was the primary reason for patients not willing to be hospitalized for isolation treatment.In addition,some patients were not willing to be hospitalized for isolation treatment due to work(42.52%),family(36.54%),excessive hospital expenses(35.88%)and self-reported mild symptoms(15.61%).Conclusion The intention of hospital isolation treatment of smear positive pulmonary tuberculosis patients in Bao′an District of Shenzhen is low.It is difficult to fundamentally solve the management problem of infectious TB patients only by supporting policies such as cost reduction.The government should carry on the compulsory legislation management to the tuberculosis infectious source.At the same time,we should actively explore other suitable and effective modes of patient isolation.