湖南省结核病医院耐多药肺结核患者治疗依从性及其影响因素研究

发布时间：2018-04-11 06:06

本文选题：耐多药结肺核 + 结核病知识知晓率　；参考：《中南大学》2013年硕士论文

【摘要】：目的：本次研究采用定量研究与定性研究相结合的方法,对耐多药肺结核患者进行问卷调查和深入访谈,了解耐多药肺结核患者治疗依从性的情况,分析影响患者依从性的影响因素,探讨干预策略,为今后提高结核病患者治疗依从性提供科学的、可靠的依据。方法：采用定量研究与定性研究相结合方法。采用自行设计的调查问卷对研究对象的一般情况、结核病知识知晓率、依从性情况进行调查,以客观描述和主要因素绝对数、均数、构成比、卡方检验、多因素logistic回归等进行描述和统计分析,并与全国总体水平或国内其他地区进行比较。结果： 1.一般情况：本次调查的研究对象中,男性102例,女性54例,各占65.4%和34.6%；年龄以45-59岁为主,占65.4%；文化程度以高中为主,占34.6%；职业以农民为主,占28.2%；已婚的占大多数,为69.2%；经济状况为一般的占大多数,达76.3%；来自农村的患者占大多数,为53.3%；以复治的为主,占57.7% 2.调查对象的结核病知识总知晓率为70.9%,全部知晓率为30.8%。其中5条核心知识的知晓率分别为：传播途径为78.2%,症状为87.8%,就诊机构为69.9%,国家免费政策为54.5%,治愈可能性为64.1%。 3.60.9%的耐多药结肺核患者的依从性良好。 4.耐多药结肺核患者中断治疗的原因主要是经济问题,占62.9%。其次是症状缓解,占45.2%。 5.性别、经济状况、结核病知识知晓率是耐多药结肺核患者治疗依从性的影响因素。女性耐多药肺结核患者的依从性是男性的3.372倍(95%CI：3.012,5.895)：经济状况为一般的耐多药肺核患者的治疗依从性是经济状况较差的耐多药结肺核患者的2.504倍(25%CI：2.272,4.806),经济状况较好的耐多药结肺核患者的治疗依从性是经济状况较差耐多药结肺核患者的2.640倍(95%CI：2.113,4.713)；结核病知识知晓率高的耐多药结肺核患者的治疗依从性是结核病知识知晓率低的耐多药结肺核患者的3.687倍(95%CI：2.963,6.614)。结论： 1.该结核病院耐药结核病患者治疗依从率为60.9% 2.中断治疗的原因主要是经济问题,其次是症状缓解。 3.本次调查对象的结核病知识总知晓率为70.9%,全部知晓率为30.8%。其中5条核心知识的知晓率分别为：传播途径为78.2%,症状为87.8%,就诊机构为69.9%,国家免费政策为54.5%,治愈可能性为64.1%。 4.男性、经济状况差、结核病知晓率低是耐药结核病患者治疗依从性的影响因素。
[Abstract]:Objective: to investigate the compliance of multi-drug resistant pulmonary tuberculosis (MDR-TB) patients with multi-drug resistance pulmonary tuberculosis (MDR-TB) by means of a questionnaire survey and in-depth interview with the method of quantitative and qualitative study.The influencing factors of patients' compliance were analyzed and the intervention strategies were discussed so as to provide a scientific and reliable basis for improving the compliance of tuberculosis patients.Methods: a combination of quantitative and qualitative studies was used.The self-designed questionnaire was used to investigate the general situation of the study subjects, the knowledge awareness rate of tuberculosis, compliance, objective description and main factors, absolute number, mean, composition ratio, chi-square test.Multivariate logistic regression was used to describe and analyze, and compared with the national level or other areas in China.Results:1.General situation: 102 males and 54 females, each accounting for 65.4% and 34.664% respectively; age 45-59 years old, 65.4%; high school education mainly, 34.6%; occupation mainly farmers, 28.2B; married, majority;69.2%; most of the patients were from rural areas, 53.3% of them were from rural areas; 57.7% of the patients were returned to treatment.2.The total awareness rate of tuberculosis knowledge was 70.9%, and the total awareness rate was 30.8%.The awareness rates of five core knowledge were 78.2%, 87.8%, 69.9%, 54.5% and 64.1% respectively.3.60.9% of multidrug resistant patients had good compliance.4.The main reason for interruption of treatment in patients with MDR was economic problems, accounting for 62.9%.The second was symptom relief, accounting for 45. 2%.5.Sex, economic status and knowledge rate of tuberculosis were the influencing factors of treatment compliance in MDR patients.The compliance of female multidrug resistant pulmonary tuberculosis patients is 3.372 times that of men's, 95% CI: 3.012 / 5.895%: the treatment compliance of patients with general economic condition of MDR pulmonary nucleus is 2.504 times of that of poor economic patients with MDR pulmonary nucleus, 25CI2.272% 4.806, and the financial condition of MDR-PNPN patients is better.The therapeutic compliance of patients with multiple drug-resistant pulmonary nuclei was 2.640 times that of patients with poor economic status and that of patients with multiple drug resistance pulmonary nuclei. 95% CI: 2.113% 4.713%; the treatment compliance of patients with multidrug resistance pulmonary nuclei with high knowledge of tuberculosis knowledge was that of patients with low knowledge of tuberculosis.3.687 times as much as 95% CI: 2.963C 6.614%.Conclusion:1.The compliance rate of drug-resistant TB patients in this hospital was 60.9%.2.The main reason for interruption of treatment is economic problems, followed by symptom relief.3.The total awareness rate of tuberculosis knowledge was 70.9%, and the total awareness rate was 30.8%.The awareness rates of five core knowledge were 78.2%, 87.8%, 69.9%, 54.5% and 64.1% respectively.4.Male, poor financial condition and low awareness rate of tuberculosis are the influencing factors of drug-resistant TB patients' treatment compliance.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R521;R197.5

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