中国防痨杂志2026，Vol.48Issue(7)：1007-1014,8.DOI:10.19982/j.issn.1000-6621.20260053
基于达标理论的出院准备服务在肺结核患者中的应用研究
Effects of intervention scheme based on the theory of goal attainment on discharge readiness of patients with pulmonary tuberculosis
摘要
Abstract
Objective:To explore the application effects of a discharge preparation service program based on King's theory of goal attainment in patients with pulmonary tuberculosis(PTB).Methods:Using purposive sampling,sixty-five patients with PTB from the TB department of Shanghai Public Health Clinical Center were enrolled as the control group(receiving routine discharge preparation)between August 2024 and October 2025.Another sixty-five PTB patients from the department of respiratory and critical care medicine were enrolled as the experimental group(receiving a discharge preparation service program based on King's theory of goal attainment).During the study period,one patient dropped out from the experimental group and two from the control group,yielding a final sample of sixty-four patients in the experimental group and sixty-three in the control group.The two groups were compared on discharge readiness,length of hospital stay,self-management behaviors(pre-and post-intervention),unplanned readmission rates within two months after discharge,and the sputum negative conversion rate at the end of the second month after discharge.Results:After the intervention,the total score on the readiness for hospital discharge scale,as well as the scores on its personal status,adaptive ability,and anticipated support subscales,were significantly higher in the experimental group(89.82±9.69,23.00(20.00,25.75),37.75(33.00,40.50),30.00(25.25,33.00))than in the control group(79.62±11.03,20.00(18.00,23.00),34.50(31.33,37.00),25.00(22.00,28.17)),with statistically significant differences(t=5.537,P＜0.001;Z=-3.608,P＜0.001;Z=—3.215,P=0.001;Z=-4.035,P＜0.001).At two months after discharge,the total score on the self-management behavior scale,as well as the scores on its treatment adherence,treatment support,and transmission prevention subscales,were significantly higher in the experimental group(82.48±2.30,23.31±1.77,29.53±1.01,29.64±0.76)than in the control group(78.05±4.27,21.63±2.76,27.78±1.87,28.63±1.73),with statistically significant differences(t=7.271,P＜0.001;t=4.068,P＜0.001;t=6.563,P＜0.001;t=4.236,P＜0.001).The unplanned readmission rate within two months after discharge in the experimental group(14.06％(9/64))was significantly lower than that in the control group(28.57％(18/63)),with a statistically significant difference(x2=3.992,P=0.046).There was no statistically significant difference(Z=-0.230,P=0.818)in length of hospital stay between the experimental group(11.00(9.00,14.00)d)and the control group(11.50(9.50,14.00)d).At the end of the second month after discharge,the sputum negative conversion rate in the experimental group(91.67％(33/36))showed no statistically significant difference(Fisher's exact test,P=0.702)compared with the control group(87.88％(29/33)).Conclusion:The discharge preparation service based on King's theory of goal attainment can effectively improve discharge readiness and self-management behavior,and reduce unplanned readmission rates within two months after discharge in patients with PTB,but has no significant effect on the length of hospital stay and sputum negative conversion rate at the end of the second month after discharge.关键词
结核,肺/病人出院/健康教育/护理理论Key words
Tuberculosis,pulmonary/Patient discharge/Health education/Nursing theory分类
医药卫生引用本文复制引用
魏潇雯,董宁,吴元浩,杨洁,杨依静,沈克兰,张林..基于达标理论的出院准备服务在肺结核患者中的应用研究[J].中国防痨杂志,2026,48(7):1007-1014,8.基金项目
复旦-复星护理科研项目(FNF202557) （FNF202557）
上海市公共卫生临床中心科研项目(KY-GW-2026-34) Fudan University Nursing Research Program(FNF202557) （KY-GW-2026-34）
Shanghai Public Health Clinical Center Research Program(KY-GW-2026-34) （KY-GW-2026-34）
