基于双重ABC-X模式以家庭为中心的结核病患儿照护方案构建及干预效果评估

Construction of a family-centered care program for children with tuberculosis based on the double ABC-X model and intervention effects evaluation

  • 摘要:
    目的 构建基于双重ABC-X模式以家庭为中心的结核病患儿照护方案并评价其应用效果。
    方法 2022年12月—2023年10月,连续纳入上海市公共卫生临床中心结核科新入院的符合标准的64例结核病患儿及其家庭作为研究对象,随机分为试验组和对照组各 32例。对照组接受儿童结核病常规护理;试验组接受基于双重ABC‑X模式以家庭为中心的照护,多学科照护团队为照护者和患儿提供个性化的信息支持和情感支持。比较两组患儿的服药依从性、照护者的照顾负担和疾病管理情况。
    结果 试验组29例、对照组 27例完成干预。干预12周时,试验组服药依从性评分高于对照组(7.72±0.45 vs 7.41±0.50,P<0.05),照顾负担评分低于对照组(31.79±13.40 vs 40.04±9.01,P<0.05),疾病管理困难评分低于对照组(30.41±12.41 vs 38.56±9.48,P<0.05),疾病管理能力评分高于对照组(36.97±7.85 vs 31.56±7.30,P<0.05);干预24周时,试验组服药依从性评分高于对照组(7.34±0.97 vs 6.70±1.14,P<0.05),照顾负担评分低于对照组(31.62±11.72 vs 39.63±10.17,P<0.05),疾病管理困难评分低于对照组(30.59±10.87 vs 37.81±9.32,P<0.05),疾病管理能力评分高于对照组(42.07±6.93 vs 35.63±7.32,P<0.05)。
    结论 基于双重ABC‑X模式以家庭为中心的照护,能够提高结核病患儿的服药依从性,减轻照护者的照顾负担和疾病管理难度,提高照护者的疾病管理能力。

     

    Abstract:
    Objective To construct a family-centered care model for children with tuberculosis based on the double ABC-X model, and to evaluate its clinical effects.
    Methods From December 2022 to October 2023, 64 newly admitted children with tuberculosis who met the criteria and their caregivers were recruited from the tuberculosis department of Shanghai Public Health Clinical Center were randomly divided into an experimental group (32 cases) and a control group (32 cases).The control group was given a conventional health care, while the experimental group was given a family-centered health care intervention based on the double ABC-X model, in which a multidisciplinary care team provided personalized information and emotional support for the caregivers and their children. Medication adherence of the children, caregiver’s teading burden, and disease management competence were compared between the 2 groups.
    Results A total of 29 cases in the experimental group and 27 cases in the control group completed the intervention. At 12 weeks of intervention, the medication adherence score (7.72±0.45 vs 7.41±0.50, P<0.05) and disease management competence score (36.97±7.85 vs 31.56±7.30, P<0.05) were higher in the experimental group than that in the control group while the caregiving burden score (31.79±13.40 vs 40.04±9.01, P<0.05) and difficulty of disease management score (30.41±12.41 vs 38.56±9.48, P<0.05) were lower than that in the control group. At 24 weeks of intervention, the medication adherence score (7.34±0.97 vs 6.70±1.14, P<0.05) and disease management competence score (42.07±6.93 vs 35.63±7.32, P<0.05) were higher in the experimental group than that in the control group as well, but the caregiving burden score (31.62±11.72 vs 39.63±10.17, P<0.05) and difficulty of disease management score (30.59±10.87 vs 37.81±9.32, P<0.05) were lower than that in the control group.
    Conclusion Family-centered care based on the double ABC-X model can effectively promote medication adherence among children with tuberculosis, reduce caregivers’ care burden and disease management difficulties, and improve caregiver’s disease management competence.

     

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