以专病管理团队为主导的疾病管理对炎症性肠病患者的效果研究

发布时间：2018-02-12 17:18

  本文关键词： 炎症性肠病 疾病管理 服药依从性 生活质量 随访　出处：《中国全科医学》2016年35期 　论文类型：期刊论文

【摘要】：目的探讨对炎症性肠病(IBD)患者实施以专病管理团队为主导的疾病管理的效果。方法采用便利抽样法,选取2014年3月—2015年2月在南京中医药大学附属医院脾胃病科就诊的IBD患者131例,采用随机数字表法将其分为对照组(65例)和干预组(66例),对照组给予常规专病门诊随访和健康教育,干预组实施以专病管理团队为主导的疾病管理和随访。采用Morisky用药依从性量表(MMAS)、IBD患者生活质量问卷(IBDQ)、医院焦虑抑郁量表(HADS)、IBD症状体征分级量化评分表分别评价患者干预前、干预第3个月、干预第6个月时用药依从性、生活质量评分、焦虑抑郁状况以及症状严重程度。结果干预方法、时间对患者MMAS评分主效应显著(P0.05);干预第3、6个月,干预组MMAS评分高于对照组(t=6.530,P0.001;t=3.813,P=0.006)。干预方法、时间对患者肠道症状、全身症状、社会功能评分以及IBDQ总分主效应显著(P0.05)。干预第3、6个月时,干预组焦虑、抑郁状况均优于对照组(P0.05)。干预方法、时间对患者IBD症状体征分级量化评分主效应显著(P0.05);干预第3、6个月,干预组IBD症状体征分级量化评分低于对照组(t=2.114,P=0.035;t=2.239,P=0.020)。结论以专病管理团队为主导的疾病管理能够有效提高IBD患者用药依从性,提高生活质量,降低焦虑、抑郁水平,改善疾病症状。
[Abstract]:Objective to investigate the effect of disease management in IBD patients with inflammatory bowel disease (IBD). From March 2014 to February 2015, 131 patients with IBD were selected from the Department of spleen and stomach Diseases, affiliated Hospital of Nanjing University of traditional Chinese Medicine. It was divided into control group (n = 65) and intervention group (n = 66) by random digital table. The control group was followed up and given health education. The intervention group carried out disease management and follow-up led by the special disease management team. The Morisky compliance scale was used to evaluate the patients' quality of life (QOL), and the hospital anxiety and depression scale (HADS) was used to evaluate the patients before intervention. At the 3rd month, the sixth month, the drug compliance, quality of life score, anxiety and depression status, and the severity of symptoms. Results the main effect of the intervention method on the MMAS score of the patients was significant (P 0.05), and at the 3rd and 6th month, the main effect of intervention was significant (P < 0.05). The MMAS score in the intervention group was higher than that in the control group (6.530g / 0.001). The intervention method was significant for the patients' intestinal symptoms, systemic symptoms, social function scores and total IBDQ scores (P 0.05). At the 3rd and 6th month after intervention, anxiety was observed in the intervention group. The depression status was better than that in the control group (P 0.05). The main effect of intervention method and time on the grading and quantification of IBD symptoms and signs was significant (P 0.05), and the intervention was at the 3rd and 6th month. The scores of IBD symptoms and signs in the intervention group were lower than those in the control group. Conclusion the disease management led by the special disease management team can effectively improve the compliance of drug use, improve the quality of life, reduce anxiety and depression, and improve the symptoms of IBD.
【作者单位】： 南京中医药大学附属医院脾胃病科;南京中医药大学附属医院护理部;
【基金】：南京中医药大学附属医院/江苏省中医院院级课题(Y14039)
【分类号】：R574
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本文编号：1506152