周燕燕 束娇娇 刘冉 郭亚丽 彭巧君

[摘要] 目的 探讨个案管理模式对结核病合并艾滋病患者自我管理能力及心理弹性的影响。 方法 选取2017年5～12月新疆维吾尔自治区第六人民医院住院接受抗结核和抗病毒治疗的患者132例，采用随机数字表法将其分为对照组和观察组，每组各66例。对照组给予常规护理管理，观察组实施个案管理模式，比较两组患者自我管理能力及心理弹性评分。 结果 干预前两组患者自我管理能力及心理弹性评分比较，差异均无统计学意义（P > 0.05）；干预后两组上述指标均高于同组干预前，观察组上述指标均显著高于对照组，差异均有统计学意义（P < 0.05）。结论 实施个案管理可以有效提高结核病合并艾滋病患者的自我管理能力，增强患者的心理弹性水平。

[关键词] 结核病；艾滋病；个案管理模式；自我管理能力；心理弹性

[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210（2018）12（b）-0154-05

[Abstract] Objective To explore the impact of case management mode on self-management ability and psychological resilience of tuberculosis patients with AIDS. Methods A total of 132 patients who received anti-tuberculosis and anti-viral treatment in Xinjiang Uygur Autonomous Region Sixth People′s Hospital from May to December 2017 were randomly divided into the control group and the observation group by random number table method， with 66 cases in each group. The control group was given routine nursing management， and the observation group was given case management model. The self-management ability and psychological elasticity scores of the two groups were compared. Results There was no significant difference in self-management ability and psychological elasticity score between the two groups before intervention （P > 0.05）. The above indexes of the two groups were higher than those of the same group before intervention， the above indexes of the observation group were significantly higher than those of the control group， the differences were statistically significant （P < 0.05）. Conclusion The implementation of case management can effectively improve the self-management ability of tuberculosis patients with AIDS and enhance their psychological resilience.

[Key words] Tuberculosis； Acquired immunodeficiency syndrome； Case management model； Self-management ability； Psychological elasticity

結核病（tuberculosis，TB）是由结核分枝杆菌引起的一种呼吸道传染性疾病。艾滋病，全称为获得性免疫缺陷综合征（acquired immunodeficiency syndrome，AIDS）是由人类免疫缺陷病毒（human immunodeficiency virus，HIV）引起的慢性传染病。TB是AIDS最常见的机会性感染[1]，TB合并AIDS是两种慢性传染性疾病，目前在全球呈高流行态势，严重威胁人类的健康。由于疾病的特殊性和敏感性，患者需要终身服药，终身治疗等[2]。因此，如何实现个体化，提高TB合并AIDS患者的生活质量，促进患者自我管理等已成为两种疾病管理工作中迫切需要解决的问题。以患者为中心的个案管理模式，具有可实现个体化、针对性强的特点，已在多种慢性疾病管理中得到广泛应用并且取得了较好的效果[3-4]。新疆TB和AIDS的发病率较高。本……