肺结核病人手机及网络利用情况及其影响因素研究

发布时间：2018-03-05 16:15

本文选题：居家化疗肺结核病人　切入点：手机　出处：《山东大学》2013年硕士论文　论文类型：学位论文

【摘要】：肺结核病(Tuberculosis, TB)是一种严重危害人类健康的慢性呼吸道传染病。目前世界卫生组织提倡的DOTS策略规定应用利福平-营养标准疗法初次感染病人需要6个月疗程,而复发病人需要8个月的疗程。由于医院,患者和肺结核疾病性质的原因,住院完成治疗全程是不可能的,因此,肺结核治疗疗程的大部分时间是通过居家化疗来完成的。肺结核病人治疗失败的主要原因是居家治疗过程中没有按照DOTS策略的规定服药。有研究表明多种提肺结核病人服药依从性的行为和方式联合运用比只使用单一干预手段效果显著。随着科学技术的进步和社会经济的发展,多种提高肺结核病人服药依从性的干预手段都可以通过手机和网络实施。手机和网络技术的应用能使多种干预手段简单化,一体化,可以大大提高干预效率。因此,我们认为应用手机和网络技术是目前提高结核病人服药依从性的最佳选择,也是未来控制和治疗结核病的发展方向。为此,本调查采用分层整群随机抽样的方法,居家化疗肺结核病人选取的是山东省长清、莒南、章丘、文登、沂水和乳山6个县级市2011年1月1日-2011年12月31日登记的720例病人,对居家化疗肺结核病病人手机网络利用情况进行描述性分析,并结合专业知识,对其影响因素进行单因素分析,之后运用非条件Logistic回归模型探寻其影响因素。本研究发现此次调查的居家化疗肺结核病病人受教育程度很低；经济状况一般或较差；单因素分析显示,年龄、教育程度、婚姻状况、职业、户口所在地、医疗保障、收入、收入来源与居家化疗的肺结核病人手机网络利用情况相关；非条件Logistic回归分析显示,文盲半文盲、学龄前儿童教育水平和已婚3个因素是居家化疗肺结核病人手机利用率低的独立危险性因素,职业为工人是居家化疗肺结核病人手机利用率高的独立保护性因素,文盲半文盲的教育水平是居家化疗肺结核病人网络利用率低的独立危险性因素。本研究认为利用短消息服务与其他干预手段联合应用提醒居家化疗的肺结核病人按时服药可行性比较大,短消息服务可以帮助医护人员更好地干预居家化疗的肺结核病人按时服药和接受检查,进一步提高患者治愈率和降低复发的可能性。仅靠这一种手段来帮助居家治疗结核病人提高服药依从性是远远不够的,医护人员也可以借助突飞猛进的网络技术资源协助病人提高服药依从性。提高居家化疗的肺结核病人服药依从性的任务仍然重大而艰巨。相信通过家庭经济收入的增长和教育水平的提高,手机和网络可作为未来防治肺结核的新平台。
[Abstract]:Tuberculosis tuberculosis (TB) is a chronic respiratory infectious disease that seriously endangers human health. At present, the DOTS strategy advocated by the World Health Organization stipulates that rifampicin-nutrition standard therapy requires a course of treatment of six months for first infected patients. Because of the nature of the hospital, the patient and the tuberculosis, it is impossible to complete the whole course of treatment in the hospital. Most of the time of the course of treatment of pulmonary tuberculosis is completed through home chemotherapy. The main reason for the failure of the treatment of pulmonary tuberculosis patients is that they do not take drugs in accordance with the DOTS strategy in the course of home treatment. Some studies have shown that there are many kinds of pulmonary nodule. The behavior and mode of drug compliance in nuclear patients were more effective than that of single intervention. With the progress of science and technology and the development of social economy, many kinds of interventions to improve the compliance of tuberculosis patients can be implemented through mobile phone and network. The application of mobile phone and network technology can simplify and integrate many kinds of interventions. Therefore, we think that the application of mobile phone and network technology is the best choice to improve the compliance of TB patients, and it is also the development direction of TB control and treatment in the future. For this reason, this investigation adopts the stratified cluster random sampling method, the home chemotherapy pulmonary tuberculosis patient selects the Shandong Province Changqing, Junan, Zhang Qiu, Wendeng, From January 1st 2011 to December 31st 2011, 720 patients registered in Yishui and Rushan county cities were analyzed on the utilization of mobile phone network in patients with pulmonary tuberculosis, and their professional knowledge was combined. The influencing factors were analyzed by univariate analysis, and then non-conditional Logistic regression model was used to explore the influencing factors. This study found that the household chemotherapeutic pulmonary tuberculosis patients were poorly educated, average or poor financial status, univariate analysis showed that age, education, marital status, occupation, residence, medical security, income, Income sources were associated with the use of mobile phone networks in patients with pulmonary tuberculosis treated with chemotherapy at home, and non-conditional Logistic regression analysis showed that illiterate and semi-literate, Three factors of preschool children's education and married are independent risk factors of low cell phone utilization rate of patients with home chemotherapy pulmonary tuberculosis, and occupational workers are independent protective factors of high cell phone utilization rate of home chemotherapy pulmonary tuberculosis patients. The education level of illiterate and semi-literate is an independent risk factor of low network utilization rate of patients with pulmonary tuberculosis. This study suggests that it is more feasible to use short message service in combination with other intervention measures to remind TB patients of home chemotherapy to take drugs on time. The short message service can help health care workers better intervene in the treatment of tuberculosis patients who live in the home and receive regular medication and examinations. It is not enough to improve the cure rate and reduce the possibility of recurrence. It is not enough to help patients with tuberculosis in their home to improve their compliance. Medical and nursing staff can also help patients improve their compliance with medication with the help of the rapid development of network technology resources. The task of improving compliance of TB patients with chemotherapy at home is still significant and arduous. It is believed that through the family economic income, the task of improving the compliance of TB patients with drug taking is still great and arduous. The growth and improvement of education, Mobile phones and the Internet can serve as a new platform for the future prevention and treatment of tuberculosis.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R195.4;R521

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