曹　岚，夏广惠，孙　捷，李志静，刘　红，朱大茹南京市胸科医院，江苏南京210029



电话回访对高龄耐多药肺结核患者的影响

曹岚，夏广惠△，孙捷，李志静，刘红，朱大茹
南京市胸科医院，江苏南京210029

［摘要］目的：探讨电话回访对高龄耐多药肺结核患者焦虑抑郁状况、遵医行为及满意度的影响。方法：将200例高龄耐多药结核患者随机分为观察组和对照组各100例，对照组给予常规出院指导，观察组在对照组的基础上于出院后1周开始定期进行电话回访，回访时间为24个月，24个月后对患者负性情绪、遵医行为、满意度及治疗效果作比较。结果：观察组负性情绪明显低于对照组(P＜0.05)，遵医行为明显优于对照组(P＜0.05)，再次入院次数、痰菌转阴率好于对照组(P＜0.05)，对医院服务满意度高于对照组(P＜0.05)。结论：电话回访可降低高龄耐多药肺结核患者的负性情绪，促进患者的遵医行为，提高患者满意度，为提高高龄耐多药肺结核患者的治愈率起到积极作用。

［关键词］耐多药肺结核；电话回访;负性情绪；遵医行为；满意度

Influence of Return Visit on the Aged Patients with Multidrug-resistant Tuberculosis by Telephone

CAO Lan,XIA Guanghui△,SUN Jie,LI Zhijing,LIU Hong,ZHU Daru
Nanjing Chest Hospital,Nanjing 210029,China

Abstract Objective:To explore the influence of return visit on anxiety,depression,the behavior of medical compliance and satisfaction degree of the aged patients with multidrug-resistant tuberculosis (MDR-TB).Methods:All 200 patients were randomized into the observation group and the control group,100 cases each group,the control group implemented conventional discharge guidance,the observation group accepted the return visit regularly by telephone in one week after discharge,the return visit time was 24 months,negative emotion,the behavior of medi-cal compliance,satisfaction degree and therapeutic effects of the patients were compared in 24 months.Results:The observation group was lower than the control group in negative emotion obviously (P＜0.05),superior to the control group obviously in the behavior of medical compliance (P＜0.05),better than the control group in the number of hospital readmission and sputumn conversion rate (P＜0.05),higher than the control group in hospital service satisfaction degrees (P＜0.05).Conclusion:Return visit by telephone could relieve negative emotion of the patients,promote their behavior of medical compliance,improve the patients' satisfaction degree,therefore to promote improving cure rate of the patients.

Keywords multidrug-resistant tuberculosis;return visit by telephone;negative emotions;the behavior of medical compliance;satisfaction degree

耐多药结核病(multidrug-resistant tuberculosis，MDR-TB)体外实验证实结核患者感染的结核分枝杆菌至少同时对一线抗结核药物中的异烟肼和利福平耐药［1］。MDR-TB具有治疗时间长、治疗难度大、治愈率低、死亡率高等特点。近年来，随着人口的老龄化程度加深，老年性肺结核有增加的趋势。调查结果显示，我国老年性肺结核有“三高一低”的特点，即患病率高、痰菌阳性率高、病死率高和治愈率低［2］。同时由于MDR-TB疗效差，使老年患者认为年龄已大，无需治疗，往往较易自动停药或拒绝治疗，对治疗的依从性差、负性情绪高。……