本文選題：結(jié)核病 + 控制現(xiàn)狀��； 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的通過對寧夏海原縣結(jié)核病患者的就醫(yī)行為調(diào)查,了解海原縣結(jié)核病患者的基本情況和結(jié)核病控制現(xiàn)狀及結(jié)核病患者發(fā)現(xiàn)過程中的延遲情況并分析其延遲的影響因素,為寧夏的結(jié)核病防控工作提供科學(xué)的理論依據(jù)和建議。方法對海原縣2012年7月1日至2013年6月30日經(jīng)過確診和已完成規(guī)范治療的所有結(jié)核病患者進行面對面的現(xiàn)場調(diào)查,結(jié)合海原縣結(jié)核病患者初診登記本和海原縣結(jié)核病疑似病人轉(zhuǎn)診單得到結(jié)核病患者基線資料。運用均數(shù)、標準差、中位數(shù)、四分位數(shù)間距對定量資料進行統(tǒng)計學(xué)描述分析,對定性資料采用構(gòu)成比進行統(tǒng)計學(xué)描述分析。分別用卡方檢驗和非條件Logistic回歸對結(jié)核病患者延遲原因進行單因素分析和多因素分析(a=0.05)。結(jié)果1.本次共調(diào)查海原縣結(jié)核病患者217人,男性107人,女性110人,平均年齡56.5±19.2歲,漢回比例為1:4.7,文化程度以文盲為主,職業(yè)以農(nóng)民為主。2.31.8%的患者在出現(xiàn)結(jié)核癥狀后未立即就醫(yī);僅有34.1%的患者有能力在結(jié)核病治療期間承擔自付部分醫(yī)療費用;在患結(jié)核病期間高達62.2%的患者因結(jié)核病的治療而負債;在治療期間,僅有56.2%的結(jié)核病患者不用其他人監(jiān)督而自行服藥,69.6%的結(jié)核病患者表示有醫(yī)務(wù)人員到家隨訪;41.5%的患者表示在治療結(jié)束時,醫(yī)生未告知其結(jié)核病是否已經(jīng)治療好;僅有13.8%的患者患結(jié)核病前了解結(jié)核病知;患者對醫(yī)院就診流程方便性滿意度為78.8%,對醫(yī)生所介紹的肺結(jié)核相關(guān)知識的滿意度為77.0%,對醫(yī)院結(jié)核科就診環(huán)境滿意度為86.2%,對醫(yī)保補助政策滿意度為60.8%。3.患者就診延遲率為57.1%,延遲中位數(shù)為51.5天,四分位數(shù)間距為94.0天;患者轉(zhuǎn)診延遲率為23.6%,延遲中位數(shù)為23.0天,四分位數(shù)間距為40.0天;患者確診延遲率為38.7%,延遲中位數(shù)為45.0天,四分位數(shù)間距為69.2天;患者發(fā)現(xiàn)延遲率為53.9%,延遲中位數(shù)為79.0天,四分位數(shù)間距為13.0天。4.文化程度、職業(yè)和出現(xiàn)結(jié)核癥狀后采取措施不同的患者就診延遲差異有統(tǒng)計學(xué)意義(P0.05);文化程度和出現(xiàn)結(jié)核癥狀后采取措施是患者就診延遲的影響因素(P0.05)。住所離鄉(xiāng)鎮(zhèn)衛(wèi)生院的距離、結(jié)核病患者首診醫(yī)療機構(gòu)不同的患者轉(zhuǎn)診延遲差異有統(tǒng)計學(xué)意義(P0.05);住所離鄉(xiāng)鎮(zhèn)衛(wèi)生院的距離和首診醫(yī)療機構(gòu)是患者轉(zhuǎn)診延遲的影響因素(P0.05)。年齡、文化程度、住所離縣結(jié)防機構(gòu)的距離、住所離鄉(xiāng)鎮(zhèn)衛(wèi)生院的距離、首診醫(yī)療機構(gòu)不同的患者確診延遲差異有統(tǒng)計學(xué)意義(P0.05);治療結(jié)核病全程花費、住所離縣結(jié)防機構(gòu)的距離、住所離鄉(xiāng)鎮(zhèn)衛(wèi)生院的距離、首診醫(yī)療機構(gòu)是結(jié)核病患者確診延遲的影響因素(P0.05)。首診醫(yī)療機構(gòu)不同的患者發(fā)現(xiàn)延遲差異有統(tǒng)計學(xué)意義(P0.05);首診醫(yī)療機構(gòu)是患者發(fā)現(xiàn)延遲的影響因素(P0.05)。結(jié)論1.結(jié)核病患者文化程度偏低,健康意識不強,接受結(jié)核病知識的方式較為被動,結(jié)核病知識知曉率低;患者收入偏低,對醫(yī)保補助政策滿意度較低,疾病負擔依然很重。很多結(jié)核病患者仍然是被動服藥,患者服藥依從性不高。2.結(jié)核病患者發(fā)現(xiàn)過程中的延遲情況不容樂觀。3.不同職業(yè)的患者間就診延遲發(fā)生存在差異;文化程度低、出現(xiàn)結(jié)核癥狀后未立即到醫(yī)療機構(gòu)就診的患者更易發(fā)生就診延遲。4.住所距鄉(xiāng)鎮(zhèn)衛(wèi)生院的距離遠和首診是縣級以下醫(yī)院的患者越易發(fā)生轉(zhuǎn)診延遲。5.不同年齡和文化程度的患者間確診延遲發(fā)生存在差異;結(jié)核病全程治療花費少、住所距鄉(xiāng)鎮(zhèn)衛(wèi)生院的距離遠、距縣結(jié)防機構(gòu)遠和首診是縣級以下醫(yī)院的患者越容易發(fā)生確診延遲。6.首診是縣級以下醫(yī)院的患者更容易發(fā)生發(fā)現(xiàn)延遲。
[Abstract]:Objective to investigate the medical behavior of patients with tuberculosis in Haiyuan County, Ningxia, to understand the basic situation of tuberculosis patients in Haiyuan County, the status of tuberculosis control and the delay in the detection of TB patients and to analyze the influencing factors of the delay, and provide scientific theoretical basis and suggestions for the prevention and control of tuberculosis in Ningxia. From July 1, 2012 to June 30, 2013 in Haiyuan County, all cases of tuberculosis patients who had been diagnosed and finished with standardized treatment were investigated in face to face, and the baseline data of TB patients were obtained from the first diagnosis registration of the patients with tuberculosis in Haiyuan county and the referral form of suspected TB patients in Haiyuan county. The average number, standard deviation, median, four division were used. The quantitative data were analyzed statistically and the qualitative data were analyzed with statistical description. Single factor analysis and multiple factor analysis (a=0.05) were used to analyze the delayed causes of tuberculosis patients with chi square test and unconditional Logistic regression. Results 1. cases were investigated in 217 cases of tuberculosis patients in Haiyuan county and 107 men. The average age of 110 people was 56.5 + 19.2 years old, the average age was 56.5 + 19.2 years, the proportion of Han Hui was 1:4.7, the education level was mainly illiterate. The patients who were mainly.2.31.8% were not immediately hospitalized after the symptoms of tuberculosis; only 34.1% of the patients had the ability to pay part of the medical expenses during the period of TB treatment, and 62.2% of the patients during the period of tuberculosis were due to the disease. In the course of treatment, only 56.2% of TB patients took their own medicine without the supervision of other people, and 69.6% of the patients were followed up by medical staff, and 41.5% of the patients said that at the end of the treatment, the doctor did not tell whether the TB had been cured; only 13.8% of the patients had a pre tuberculosis understanding. The patient's satisfaction with the hospital consultation process was 78.8%, the satisfaction of tuberculosis related knowledge introduced by the doctors was 77%, the degree of satisfaction to the hospital tuberculosis department was 86.2%. The delay rate of 60.8%.3. patients was 57.1%, the median delayed median was 51.5 days, and the four quantile interval was 94. The delayed rate was 23.6%, the delayed median was 23 days, the four digit spacing was 40 days, the patient's delay rate was 38.7%, the delayed median was 45 days, the four digit spacing was 69.2 days, the delayed rate was 53.9%, the delayed median was 79 days, the four digit interval was 13 days.4. culture, occupation and tuberculosis. There was statistical significance (P0.05) for patients with different measures after taking different measures, and the influence factor (P0.05) on the delay of patient visits after the onset of tuberculosis symptoms (P0.05). The distance between the residence and the township hospital was significant (P0.05). The distance from the township hospital and the first visit medical institution were the factors affecting the patient's delay of referral (P0.05). Age, the education level, the distance from the shelter from the county and the distance from the township hospital, the difference of the delay in the diagnosis of different patients in the first medical institutions (P0.05); the whole course of treatment of tuberculosis and residence. The distance between the county and the village, the distance between the residence and the township hospital, the first medical institution was the influence factor of the delay of diagnosis of tuberculosis patients (P0.05). The difference of the delay was statistically significant (P0.05). The first medical institution was the influence factor of the patient's discovery delay (P0.05). Conclusion 1. tuberculosis patient culture Low level, poor health awareness, passive tuberculosis knowledge, low awareness of tuberculosis knowledge, low income of patients, low satisfaction with medical insurance subsidy policy, and still heavy burden of disease. Many patients with tuberculosis are still passively taking medicine and the patient's compliance is not high in.2. tuberculosis patients. It is not optimistic that there is a difference in the delay between patients with different professions. The low education level, the patients who have not immediately come to the medical institution after the symptoms of tuberculosis are more likely to have a delay in visiting the hospital and the distance of the.4. residence is far away from the township health center and the first diagnosis is that the more susceptible the patients at the county level hospital are to delay.5. and the different ages and cultures of.5.. There is a difference in the degree of delayed diagnosis between patients; the cost of the whole course of tuberculosis treatment is less, the distance from the residence distance from the township hospital is far. The patient with the county hospital in the county below and the first diagnosis is the easier to delay the diagnosis of the first diagnosis of the.6..

【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R52

【參考文獻】

相關(guān)期刊論文 前10條

1 楊利平;李蓉;康曉麗;何惠軍;李國華;王濤;;寧夏平羅縣連續(xù)10年肺結(jié)核病患者痰檢結(jié)果分析[J];中國消毒學(xué)雜志;2016年05期

2 殷玉華;李正直;喬慧;楊甲飛;歐陽恒麗;段紅菊;;寧夏貧困縣確診結(jié)核患者服藥依從性現(xiàn)狀及其影響因素[J];中國公共衛(wèi)生;2015年11期

3 婁泉偉;陳潔穎;葛陽;;肺結(jié)核患者就診與確診延遲因素研究[J];浙江預(yù)防醫(yī)學(xué);2015年09期

4 王榮;李晨;楊晨;孫照平;;南京市2011-2013年肺結(jié)核患者就診延遲狀況及影響因素分析[J];中華疾病控制雜志;2015年08期

5 唐南;許琳;;云南省2005年與2013年涂陽肺結(jié)核患者就診延遲變化分析[J];公共衛(wèi)生與預(yù)防醫(yī)學(xué);2015年02期

6 陳妙玉;莫實德;;肺結(jié)核患者治療依從性及其影響因素[J];廣西醫(yī)學(xué);2015年01期

7 仇桑桑;陸慧;張思a\;姜偉;黃莉芳;王建明;;結(jié)核病患者疾病經(jīng)濟負擔比較研究[J];南京醫(yī)科大學(xué)學(xué)報(社會科學(xué)版);2014年05期

8 王曉林;趙曉;肖慧霞;石峰;楊正貴;楊旭霞;潘麗;;2010年寧夏結(jié)核病流行病學(xué)抽樣調(diào)查分析[J];寧夏醫(yī)學(xué)雜志;2014年09期

9 吳騰燕;劉飛鷹;黃曙海;梁大斌;;廣西新發(fā)涂陽肺結(jié)核患者確診延遲影響因素分析[J];中國臨床新醫(yī)學(xué);2014年02期

10 葉浩森;董曉欣;侯萬里;盧祖洵;;DOTS策略在結(jié)核病防治中的應(yīng)用進展和存在的問題[J];公共衛(wèi)生與預(yù)防醫(yī)學(xué);2013年04期

相關(guān)會議論文 前1條

1 謝少三;;肺結(jié)核病人發(fā)現(xiàn)延遲分析(摘要)[A];中華醫(yī)學(xué)會第六屆全國結(jié)核病學(xué)術(shù)大會論文匯編[C];2000年

相關(guān)博士學(xué)位論文 前1條

1 汪雁鶴;DOTS策略的效果及影響因素分析[D];復(fù)旦大學(xué);2004年

相關(guān)碩士學(xué)位論文 前2條

1 袁慶;山東省流動人口肺結(jié)核病人就診延遲及其影響因素分析[D];山東大學(xué);2009年

2 顏鳳霞;山東省農(nóng)村肺結(jié)核病人衛(wèi)生系統(tǒng)延遲及影響因素研究[D];山東大學(xué);2008年

，

本文編號：1839678