The Research Of The CCM In The Operative Patients With Spinal Tuberculosis After Discharge

ObjectiveTo research of the collaboration care model on the compliance behavior,quality oflife,Scores of pain and daily activity of operative spinal tuberculosis patients afterdischarge. so as to provide the reference basis of elevating self management ability of theoperative spinal tuberculosis patients after discharge.MethodsThis study used a quasi-experimental study.Between September2012and February2013,Ninety operative patients with spinal tuberculosis were recruited from the two TBprevention and control center in changsha city randomly allocated to the interventiongroup (n=45) and the control group (n=45). All of patients were3-4weeks aftersurgery,25-80years old and excluded the patients with severe cognitive deficit. Theintervention group accepted nursing intervention based on the collaboration care modelafter discharge,the control group accepted routine nursing intervention after discha-rge.Three questionnaires,including MMAS-8-item version,compliance of functional ex-ercises,SF-36,Modified Barthel index (MBI) and VAS after3months,6months interventionwere used to evaluate the outcomes of the intervention effect. Data were analyzed by thefollowing statistical methods such as the Description Analyze, Independent t-test and theChi-square Test with SPSS18.0.ResultsAt the end of the intervention, a total of83cases of patients with complete datacollection.2cases died,2cases were lost to follow-up,41patients completed research theintervention group;1case death,2cases were lost to follow-up,42patients completed thestudy in the control group. (1)Before intervention,the patients’score of the drug compliance were (7.90±0.23)(7.79±0.38),the differences of patients’score of the drug compliance scores betweenintervention and control group were nonsignifieant (P>0.05); After1mouth and3mouthsintervention，the patients’score of the drug compliance in intervention groups were(7.32±0.86),(7.27±0.90), higher than the control groups (6.87±1.15),(6.30±1.07), therewere significance difference (P<0.05);After6mouths intervention, The patients’score ofthe drug compliance in intervention groups were (7.25±0.86),Higher than the controlgroup(5.97±1.05), There was significance difference(P<0.01);Repeated measu-resANOVA reaveald significant group main effect and time effect on the score of the drugcompliance(P<0.01).(2)After3mouths intervention, the compliance of functional exercises were found nosignificantly different between the2groups(P<0.05); After6mouths intervention, thecompliance of functional exercises were found significantly different between the2groups(P<0.05).(3)After3mouths intervention,the SF-36dimensions were found significantly differentbetween the2groups (P<0.05) except for General Health,Vitality and Role Emotional(P>0.05);After6mouths intervention,the SF-36dimensions were found significantlydifferent between the2groups (P<0.05) except for Vitality and Role Emotional (P>0.05).(4)After3mouths intervention,the scores of VAS in intervention group were (3.36±0.82),Lower than the control group(3.84±0.86),there was significance difference (P<0.05);After6mouths intervention,the scores of VAS in intervention group were (2.14±0.84),lowerer than the control group(2.76±0.76),there was significance difference (P<0.01).(5)After3mouths intervention,the scores of MBI in the intervention group were(84.17±13.06),higher than the control group (76.10±21.34),there was the significancedifference(P<0.05);After6mouths intervention,the scores of MBI in the interventiongroup were (95.73±8.52),higher than the control group(89.16±12.49), there wassignificance difference (P<0.01).ConclusionThe nursing intervention which based on the collaborative care can promoted the compliance behavior,improve the operation quality of life,alleviate postoperative pain,promote wound healing, improve the ability of patients with daily activities,reduce thevalue of ESR and CRP in operative patients with spinal tuberculosis after discharge.