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目的研究糖尿病并发肺结核老年患者健康素养与治疗效果的关系,为提高肺结核治疗效果提供依据。方法采用方便抽样方法选取在遵化市人民医院治疗的糖尿病并发肺结核患者214例进行随访;采用健康素养量表、治疗依从性量表进行评价,结合肺结核病灶和血糖控制情况分析患者的健康素养水平与治疗依从性及预后的关系。结果高健康素养组患者结核病灶控制总有效率为83.65%,血糖控制达标率为92.30%,均高于低健康素养组的60.00%和67.27%(P<0.05);多因素Logistic回归分析结果显示高健康素养(OR=0.570,95%CI:0.380~0.886)和高治疗依从性(OR=0.215,95%CI:0.052~0.884)是糖尿病并发肺结核患者治疗预后的保护因素;而女性(OR=1.806,95%CI:1.175~2.776)、空洞型肺结核(OR=3.005,95%CI:1.369~6.598)、合并其他疾病(OR=1.582,95%CI:1.039~2.408)、血糖控制不良(OR=2.241,95%CI:1.328~3.386)、营养风险评分≥3分(OR=2.371,95%CI:1.387~4.052)以及家庭功能总评分<3分(OR=1.624,95%CI:1.092~2.461)是糖尿病并发肺结核患者治疗预后的危险因素。高健康素养组患者的吸烟、饮酒、饮食、康复锻炼和用药情况均优于低健康素养组(P<0.05)。结论糖尿病并发肺结核患者的肺结核治疗效果与健康素养有关,健康素养越高,治疗依从性越好,预后愈佳。
Objective To study the relationship between health literacy and treatment effect of elderly patients with diabetes mellitus complicated with pulmonary tuberculosis and to provide basis for improving the therapeutic effect of pulmonary tuberculosis. Methods A total of 214 diabetic patients with pulmonary tuberculosis who were treated in Zunhua People’s Hospital were enrolled in this study. The health literacy scale and treatment adherence scale were used to evaluate the patients’ health literacy, combined with pulmonary tuberculosis and glycemic control Relationship with treatment compliance and prognosis. Results The total effective rate of tuberculosis control in high health literacy group was 83.65% and the compliance rate of blood glucose control was 92.30%, which were higher than 60.00% and 67.27% in low health literacy group (P <0.05). The multivariate Logistic regression analysis showed that High health literacy (OR = 0.570, 95% CI: 0.380-0.886) and high treatment compliance (OR = 0.215, 95% CI: 0.052-0.884) were the protective factors in the treatment of patients with pulmonary tuberculosis due to diabetes mellitus. (OR = 3.005, 95% CI: 1.369-6.598), other diseases (OR = 1.582, 95% CI: 1.039-2.458), poor glycemic control = 2.241, 95% CI: 1.328 ~ 3.386), nutritional risk score ≥3 (OR = 2.371,95% CI: 1.387-4.05 2) and family functional total score <3 (OR = 1.624,95% CI 1.092 ~ 2.461) is a risk factor for the prognosis of patients with diabetes and pulmonary tuberculosis. Smoking, alcohol consumption, diet, rehabilitation exercises and medication in patients with high health literacy group were better than those in low health literacy group (P <0.05). Conclusions The therapeutic effect of tuberculosis in patients with diabetes complicated with pulmonary tuberculosis is related to health literacy. The higher the health literacy, the better the treatment compliance, the better prognosis.