Research On The Influence Of Case Management Model On Self-management Ability And Quality Of Life Of Patients With Tuberculosis And AIDS

Objective:1)Understand the self-management ability,psychological elasticity,self-efficacy and quality of life of patients with tuberculosis and AIDS.2)Discuss the impact of case management mode on self-management ability,psychological elasticity,self-efficacy and quality of life of patients with tuberculosis and AIDS.3)Analyze the effect of case management mode on follow-up,drug compliance and immunodetection indicators（CD₄⁺T lymphocyte count）in patients with tuberculosis and AIDS.Methods:A total of 152 patients with tuberculosis and AIDS who were hospitalized in a tertiary infectious disease hospital in Xinjiang from July 2017 to July 2018 were selected.The randomized digital table method was used to divide the subjects into the control group and the observation group according to the intervention method.There were 76 cases in each group.On the basis of the homogenized drug treatment program,the control group was given infectious disease routine management,and the observation group was given infectious disease case management.The study intervention time was 6 months.To evaluate the changes of self-management ability,psychological elasticity,self-efficacy,quality of life,drug compliance and CD₄⁺T lymphocyte counts before and after intervention in the two groups of patients.The effects of two management modes on self-management ability and quality of life of patients with tuberculosis and AIDS were analyzed.Results:1)Baseline data survey results showed that there were no significant differences in demographic data,disease status,self-management ability,psychological elasticity,self-efficacy and quality of life between the two groups（P>0.05）,which was comparable.2)Multiple stepwise regression analysis showed that education level,professional knowledge,self-efficacy,psychological elasticity and quality of life were the influencing factors of self-management ability of patients with tuberculosis and AIDS.3)The self-management ability,psychological elasticity,self-efficacy and quality of life of the two groups were lower before intervention.Repeated measures analysis of variance:the total score of self-management ability,psychological elasticity,self-efficacy,quality of life and each dimension were significantly different between the two groups（P<0.05）.The total score of self-management ability,psychological elasticity,self-efficacy,quality of life and each dimension of the two groups all changed with time,and the scores of the patients in the observation group were higher than those in the control group（P<0.05）.The total score of self-management ability,psychological elasticity,self-efficacy,quality of life and the total score of each dimension were significantly different in the interaction of time and group factors（P<0.05）.4)3 months and 6 months after intervention,there was a significant difference in follow-up and drug compliance between the two groups（P<0.05）,and the timely follow-up rate and drug compliance of the observation group were higher than those of the control group.5)6 months after intervention,there was a significant difference in CD₄⁺T cell counts between the two groups（P<0.05）.Repeated measures analysis of variance:there were significant differences in the number of CD₄⁺T cells in different time points,time and group interaction between the two groups（P<0.05）.Conclusion:The self-management ability,psychological elasticity,self-efficacy and quality of life of patients with tuberculosis and AIDS are generally at a low level.The case management model can effectively improve patients’self-management ability,psychological elasticity,self-efficacy,quality of life and drug compliance.It can also promote the growth of patients’CD₄⁺T cell counts within the normal range.These factors will help to cultivate and improve patients’self-management ability and improve their quality of life.