【摘要】 选择2015年1月1日至2016年12月31日在新乡医学院第一附属医院初次治疗的60例结核性脑膜炎患者作为研究对象。60例患者分别入住4个病区,其中第一、二病区的患者列入观察组,第三、四病区的患者列入对照组,每组各30例患者。对照组采用常规的健康教育模式,于入院时介绍住院规则、常用检查和化验的注意事项,发放健康教育读物;观察组在常规健康教育模式的基础上建立个人健康教育档案,实施个案管理的模式,由个案管理护士进行个体评估,制订个案管理计划并实施。出院时,观察组对护士工作满意25例(83.3%),基本满意5例(16.7%),不满意0例(0.0%),满意度(100.0%,30/30)明显高于对照组[满意15例(50.0%),基本满意11例(36.7%),不满意4例(13.3%);满意度为86.7%(26/30)],差异有统计学意义(X~2=8.75,P=0.013);观察组对结核性脑膜炎的治疗知识、饮食知识、休息和运动注意事项、药物知识、防止出现耐药措施等知识的得分[分别为(18.54±0.23)、(19.14±0.32)、(18.54±0.31)、(19.01±0.11)、(19.16±0.25)分]均明显高于对照组[分别为(13.41±0.43)、(15.21±0.33)、(15.21±0.56)、(14.54±0.14)、(15.76±0.34)分],差异均有统计学意义(t=12.48,P=0.005;t=11.63,P=0.012;t=8.91,P=0.021;t=11.98,P=0.010;t=10.30,P=0.016);出院后1、3、6个月观察组服药依从性高的比率分别为100.0%(30/30)、93.3%(28/30)、86.7%(26/30),均明显高于对照组[分别为85.7%(24/28)、60.7%(17/28)、53.6%(15/28)],差异均有统计学意义(X~2=4.60,P=0.032;X~2=8.86,P=0.003;X~2=7.66,P=0.006)。个案管理模式应用于结核性脑膜炎患者的管理,能提高患者对护理工作的满意度,提高患者对疾病知识的掌握程度和遵医行为。更多还原

【Abstract】 The 60 patients with tuberculous meningitis, who were newly treated at the First Affiliated Hospitail of Xinxiang Medical University from 1 January 2015 to 31 December 2016,were selected as the research subjects.The 60 patients were hospitalized in four wards of tuberculosis department.Thirty patients in the first and second wards were selected as the observation group and another 30 patients in the third and fourth wards as control group.The control group was applied with routine health education pattern including notifying the patients of rules of hospitalization, common inspections, and laboratory tests and offering them with health education materials.The observation group was applied with case management model on the basis of the routine health education.Personal health education profile was established, individual assessment was conducted by the nurse in charge, and the individual management plan was also drawn up and implemented.At discharge, all the patients in the observation group were satisfied with the nurse(completely satisfied in 25(83.3%) cases, basically satisfied in 5(16.7%) cases, and dissatisfied in 0(0.0%) cases), and only 86.7% of the patients in control group were satisfied with the nurse(completely satisfied 15(50.0%) cases, basically satisfied with 11(36.7%) cases, and dissatisfied with 4(13.3%) cases).The difference in the degree of satisfaction for nurse was statistically significant(X~2 =8.75,P=0.013) between two groups.In the observation group, the scores for knowledge acquisition of treatment of tuberculous meningitis, dietary knowledge, notices for rest and exercise, knowledge of drugs, and knowledge acquisition of measures to prevent drug resistance were(18.54±0.23),(19.14±0.32),(18.54±0.31),(19.01 ±0.11),and(19.16 ± 0.25),which were significantly higher than those in the control group((13.41± 0.43),(15.21 ±0.33),(15.21 ±0.56),(14.54±0.14),and(15.76±0.34)).The differences were statistically significant(t=12.48, P=0.005; t=11.63, P=0.012; t= 8.91, P = 0.021; t=11.98, P = 0.010; t=10.30, P =0.016).At 1,3,and 6 months after discharge, the treatment compliance rate in the observation group were100.0%(30/30), 93.3%(28/30), and 86.7%(26/30), respectively, which were significantly higher than those in the control group(85.7%(24/28), 60.7%(17/28), and 53.6%(15/28), respectively); the difference was statistically significant(X~2=4.60, P=0.032; X~2 =8.86, P=0.003;X~2 =7.66, P=0.006).In conclusion, the application of case management model in the management of patients with tuberculous meningitis could greatly improve the degree of patient’s satisfaction with nursing care,enhance the knowledge acquisition of the disease, and improve the treatment compliance.更多还原