【摘要】 目的 了解个体化健康教育对天津市肺结核患者结核病核心知识知晓率、服药依从性和自我效能的影响。方法 采用随机对照研究设计，以2022—2023年新登记纳入社区管理的活动性肺结核患者为研究对象，以易督导管理系统为平台，将患者分为对照组（275例）和干预组（109例），对干预组定期有针对性地推送符合患者个体化需求的健康知识，采用结核病核心知识问卷、Morisky依从性量表和服药自我效能量表对患者进行调查，获得肺结核患者的结核病核心知识知晓率、服药依从性和自我效能水平。结果 总知晓率为79.17%(304/384)，对照组和干预组核心信息总知晓率分别为76.15%(83/109)和80.06%(221/275)；干预组依从性高的患者比例高于对照组（37.36%vs 26.14%，χ~2=7.067,P<0.01）；干预组自我效能得分（52.0分）高于对照组（50.5分），差异有统计学意义（Z=-2.845,P<0.01）；干预组规则服药的比例（32.73%,90/275）要远高于对照组（9.17%,10/109），差异有统计学意义（χ~2=22.484,P<0.01）；干预组服药率的中位数（78.36%）也高于对照组（35.38%），差异有统计学意义（Z=-5.439,P<0.01）。结论 对肺结核患者采取多次有针对性地进行肺结核相关知识健康教育、心理疏导、智能工具提醒服药等措施，有助于提高肺结核患者的服药依从性，值得在肺结核患者社区健康管理工作中进行推广。更多还原

【Abstract】 Objective To understand the effects of individualized health education on knowledge awareness,medication compliance and self-efficacy of tuberculosis patients in Tianjin. Methods A randomized controlled study was conducted. The active pulmonary tuberculosis patients newly registered and included in community management from 2022 to 2023 were taken as the research objects,and the easy supervision management system was used as the platform. The patients were divided into control group(275cases) and intervention group(109 cases),the intervention group was regularly provided health knowledge which met the individual needs of patients. Tuberculosis core knowledge questionnaire,Morisky compliance scale and medication self-efficacy scale were used to investigate the patients,and the awareness rate of tuberculosis core knowledge,medication compliance and self-efficacy of tuberculosis patients were obtained. Results The total awareness rate of core information was 79.17%(304/384). 76.15%(83/109)and 80.06%(221/275) were in control group and intervention group,respectively. The proportion of patients with high compliance in the intervention group(37.36%) was higher than that in the control group(26.14%)（ χ~2=7.067,P<0.01）. The self-efficacy score of the intervention group(52.0 points) was higher than that of the control group(50.5 points),and the difference was statistically significant(Z=-2.845, P<0.01). The proportion of regular medication in the intervention group(32.73%,90/275) was much higher than that in the control group(9.17%,10/109),and the difference was statistically significant （ χ~2=22.484,P<0.01）. The median medication rate of the intervention group(78.36%) was also higher than that control group(35.38%),and the difference was statistically significant(Z=-5.439,P<0.01). Conclusion Several targeted measures such as health education,psychological counseling and intelligent tool reminding to take medicine for tuberculosis patients can help improve the medication compliance of tuberculosis patients,which is worthy of promotion in the community health management of tuberculosis patients.更多还原