贵州省社区医生对结核病管理现状及需求调查

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　　[摘要] 目的 探究贵州省社区医生对继续期治疗结核病患者的管理现状及需求。方法 设计调查问卷对2016年1—12月期间贵州省继续期治疗结核病患者随机抽取进行问卷调查，在获取调查对象知情同意后，调查患者一般信息，患者对社区结核病卫生服务了解情况，社区对其管理情况，对社区管理的需求。结果 患者对社区管理平均满意度达60%，社区管理采用电话方式较多，占所有方式的80%以上，社区对可疑结核者能做到早发现、早诊断、早治疗，患者对社区提醒做痰检，对漏服药、中断治疗者提醒继续治疗接受度超过85%，部分患者因不愿意隐私暴露、认为自己能坚持服药，不接受管理。结论 社区对结核病管理现状患者满意度较高，但仍存在部分患者不愿接受管理或对某些管理接受度较低情况。
　　[关键词] 管理现状;结核病;需求;调查
　　[中图分类号] R54 [文献标识码] A [文章编号] 1672-5654（2019）07（c）-0011-03
　　Investigation on Current Situation and Demand of Community Doctors for Tuberculosis Management in Guizhou Province
　　LIU Guang-hui1， ZHENG Jiao2， CHEN Wei3
　　1.Yuqing County Center for Disease Control and Prevention， Yuqing， Guizhou Province， 564499 China; 2.School of Public Health， Guizhou Medical University， Guiyang， Guizhou Province， 550002 China; 3.Department of Tuberculosis Prevention， Guizhou Center for Disease Control and Prevention， Guiyang， Guizhou Province， 550002 China
　　[Abstract] Objective To explore the management status and needs of community doctors in continuing treatment of tuberculosis patients in Guizhou province. Methods The questionnaire was designed to conduct a questionnaire survey on the tuberculosis patients of continuous treatment in Guizhou province from January to December 2016. After obtaining the informed consent of the respondents， the general information of the patients the patients' understanding of community tuberculosis health services， community management and the demand for community management were investigated. Results The average satisfaction of the community management was 60%， and phone was the main method in community management， accounting for more than 80%. For suspected tuberculosis， the community management can do early detection， early diagnosis， and early treatment. For the service of community to remind to do sputum examination， to take medicine， and to continue the treatment after interruption， the patients’ acceptance was more than 85%. Some patients who were reluctant to expose their privacy and believed that they could adhere to medication， did not accept the management. Conclusion The patients’ satisfaction of community management is high. But there are still some patients who are reluctant to it.
　　[Key words] Management status; Tuberculosis; Demand; Investigation
　　 結核病是临床常见、多发的传染病，为结核杆菌感染所致，发病部位以肺部为主，骨骼、脑膜、颈淋巴、皮肤等也会继发感染，此病具有一定潜伏期，一般在4～8周，症状以咳嗽、低热、乏力等为主[1]。若不及时治疗，不仅给患者造成痛苦，还会造成疾病传染。目前多以抗结核药物进行治疗，但由于疾病病程长，长期用药毒副作用大，尤其对于继续期患者，此时期患者症状改善不明显，加之用药的不适感，导致其依从性降低，出现不规律用药，这不仅会降低疾病治疗效果，还会导致病情迁延不愈[2]，因此有效监督管理对患者疾病控制有重要意义。随着社区卫生服务的发展，有学者提出由社区医生对继续期患者给予全程追踪、督导、治疗管理，这不仅能提高患者疾病控制率，还能有效缓解医院资源压力[3]。但大量研究表明社区卫生服务工作开展仍存在一定困难，故该文于2016年1—12月通过对贵州省继续期治疗结核病者进行问卷调查，探究患者对社区结核病卫生服务了解、利用及需求情况，从而总结经验、分析问题，为提高社区服务水平、疾病治疗效果提供参考依据。报道如下。
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