Abstract
This retrospective
study aimed to explore the effect of specialized nursing interventions on the
treatment outcome of patients with tuberculous arthritis. A total of 26
patients with tuberculous arthritis admitted to our hospital were included,
with 13 cases in the intervention group and 13 cases in the control group. The
control group received routine nursing care, while the intervention group
received specialized nursing interventions on the basis of routine care. The
primary outcome was the time to achieve clinical remission and the secondary
outcomes included pain score (VAS), joint function score (HAQ), compliance with
anti-tuberculosis treatment and incidence of adverse reactions. The results
showed that the time to clinical remission in the intervention group was
significantly shorter than that in the control group (P<0.05). At 4 and 8
weeks after intervention, the VAS score and HAQ score in the intervention group
were significantly lower than those in the control group (P<0.05). The
compliance rate of anti-tuberculosis treatment in the intervention group was
significantly higher than that in the control group (P<0.05) and the
incidence of adverse reactions was significantly lower than that in the control
group (P<0.05). Specialized nursing interventions can effectively promote
the recovery of patients with tuberculous arthritis, improve joint function,
enhance treatment compliance and reduce adverse reactions.
Keywords: Tuberculous arthritis; Anti-tuberculosis treatment; Clinical
remission
Introduction
Tuberculous arthritis
is a chronic infectious disease caused by Mycobacterium tuberculosis invading
the joint, which can lead to joint pain, swelling, dysfunction and even
disability if not treated in time1. The course of the disease is long and the treatment
requires long-term anti-tuberculosis drugs, so the nursing work is particularly
important2. However, there is a lack of targeted nursing
research on tuberculous arthritis. This study retrospectively analyzed 26
patients with tuberculous arthritis to evaluate the effect of specialized
nursing interventions, hoping to provide a reference for clinical nursing work3.
Methods
Study design and
participants
A retrospective analysis was performed on 26
patients with tuberculous arthritis diagnosed by clinical symptoms, laboratory
tests and imaging examinations in our hospital. Inclusion criteria: meeting the
diagnostic criteria of tuberculous arthritis; age 18-65 years; complete
clinical data. Exclusion criteria: combined with other severe infections;
severe 心肝 and kidney dysfunction; mental disorders;
unable to cooperate with treatment and nursing.
Grouping and interventions
According to the
different nursing methods, the patients were divided into control group and
intervention group, with 13 cases in each group.
• Control group: Routine nursing care, including basic life care, drug guidance, vital sign monitoring and health education on disease-related knowledge.
• Intervention group: On the basis of routine nursing, specialized nursing interventions were implemented:
• Psychological nursing: Establish a good nurse-patient relationship, communicate with patients regularly, understand their psychological state, provide targeted psychological counseling and help them establish confidence in overcoming the disease.
• Anti-tuberculosis drug nursing: Formulate a drug taking schedule, remind patients to take drugs on time and in quantity, explain the efficacy and possible adverse reactions of drugs and guide patients to observe and report adverse reactions in time.
• Joint function nursing: According to the patient's condition, formulate personalized joint function exercise plans, guide patients to carry out appropriate functional exercises, such as joint flexion and extension, rotation, etc., to prevent joint stiffness and muscle atrophy.
• Nutritional support nursing: Evaluate the patient's nutritional status, formulate a reasonable diet plan and guide patients to eat more high-protein, high-vitamin and high-calorie foods to improve their immunity.
Outcome measures
Primary outcome: Time to clinical
remission, which was defined as the disappearance of joint pain and swelling
and the improvement of joint function by more than 50%.
Secondary outcomes:
• Pain score: Evaluated by Visual Analogue Scale (VAS), with a score range of 0-10 points and the higher the score, the more severe the pain. It was evaluated at 4 and 8 weeks after intervention.
• Joint function score: Evaluated by Health Assessment Questionnaire (HAQ), with a score range of 0-3 points and the higher the score, the worse the joint function. It was evaluated at 4 and 8 weeks after intervention.
• Compliance with anti-tuberculosis treatment: Evaluated by the rate of taking drugs on time and completing the course of treatment, with compliance rate = (number of compliant cases / total number of cases) × 100%.
• Incidence of adverse reactions: Including gastrointestinal reactions, liver function damage, allergic reactions, etc.
Statistical analysis
SPSS 25.0 statistical
software was used for data analysis. Measurement data were expressed as mean ±
standard deviation (x±s) and t-test was used for comparison between groups.
Count data were expressed as rate (%) and χ² test or Fisher's exact test was
used for comparison between groups. P<0.05 was considered statistically
significant.
Results
General information of the two groups
There was no
significant difference in age, gender, disease course, involved joints and
disease severity between the two groups (P>0.05), which was comparable (Table
1).
Table 1: Comparison of general
information between the two groups
|
Characteristics |
Intervention Group (n=13) |
Control Group (n=13) |
P value |
|
Age (years, x±s) |
42.5±8.3 |
43.2±7.9 |
0.812 |
|
Gender (male/female, n) |
8/5 |
7/6 |
0.751 |
|
Disease course (months, x±s) |
6.2±2.1 |
5.8±1.9 |
0.603 |
|
Involved joints (knee/hip/ankle, n) |
6/4/3 |
5/5/3 |
0.902 |
|
Disease severity (mild/moderate/severe, n) |
5/6/2 |
4/7/2 |
0.876 |
Comparison of primary outcome
The time to clinical
remission in the intervention group was (8.5±2.3) weeks, which was
significantly shorter than that in the control group (12.3±3.1) weeks (t=3.826,
P<0.001) (Table 2).
Table 2: Comparison of time to
clinical remission between the two groups (weeks, x±s)
|
Group |
n |
Time to Clinical Remission |
P value |
|
Intervention Group |
13 |
8.5±2.3 |
<0.001 |
|
Control Group |
13 |
12.3±3.1 |
- |
Discussion
Tuberculous
arthritis is a chronic disease that requires long-term treatment and nursing.
Specialized nursing interventions can improve the treatment effect by
addressing the specific needs of patients4. In this study, the
time to clinical remission in the intervention group was significantly shorter
than that in the control group, indicating that specialized nursing can promote
the recovery of the disease. This may be related to the fact that specialized
nursing can improve patients' compliance with treatment, ensure the
effectiveness of anti-tuberculosis drugs and promote joint function recovery
through reasonable functional exercises5.
In terms of pain
relief, the VAS scores in the intervention group were significantly lower than
those in the control group at 4 and 8 weeks after intervention. This is because
psychological nursing can reduce patients' anxiety and depression, thereby reducing
their perception of pain and appropriate functional exercises can promote local
blood circulation and relieve pain6.
For joint function,
the HAQ scores in the intervention group were significantly better than those
in the control group, which is due to the personalized joint function exercise
plans formulated in specialized nursing. These exercises can prevent joint stiffness
and muscle atrophy and improve joint mobility7.
In addition, the
compliance rate of anti-tuberculosis treatment in the intervention group was
significantly higher and the incidence of adverse reactions was significantly
lower. This is because specialized nursing includes detailed drug guidance,
which can help patients understand the importance of taking drugs on time and
in quantity and timely detect and deal with adverse reactions, thereby
improving compliance and reducing the occurrence of adverse reactions8.
The limitations of
this study are the small sample size and single-centre retrospective design,
which may affect the generalization of the results. In the future,
multi-centre, large-sample prospective studies are needed to further verify the
effect of specialized nursing interventions.
Conclusion
Specialized nursing interventions
can effectively shorten the time to clinical remission of patients with
tuberculous arthritis, relieve pain, improve joint function, enhance treatment
compliance and reduce adverse reactions. It is worthy of clinical promotion and
application.
References