结核病患者家庭复原力水平及影响因素的纵向研究

Family Resilience and Its Influencing Factors among Tuberculosis Patients: A Longitudinal Study

摘要: 目的：了解结核病患者6个月内家庭复原力水平变化轨迹及其影响因素。方法：分别在患者住院确诊期(T1)、出院后1个月(T2)、出院后3个月(T3)、出院后6个月(T4)4个时间点上，采用纵向研究设计的方法。应用一般资料调查表、家庭复原力量表、医学应对方式问卷、社会支持评定量表、家庭关怀度指数测评表对148例结核病患者进行跟踪调查。结果：4个时间点结核病患者家庭复原力总分依次为(98.51 ± 11.15)分、(100.01 ± 10.00)分、(100.83 ± 9.57)分、(102.18 ± 8.81)分。广义估计方程进行多因素分析后发现，患者的民族、婚姻状况、家庭月收入水平、合并症以及家庭关怀指数，均对家庭复原力的动态变化产生显著影响(均P < 0.05)。结论：结核病患者出院6个月家庭复原力得分随着时间变化整体呈升高趋势，表明家庭在应对疾病压力过程中具有一定的自我调适与恢复能力。然而，该变化趋势受到多种因素影响，应重点关注民族地区、离异、家庭收入较差、有合并症、家庭关怀指数不高的患者，制定针对性干预策略，如开发具有文化习俗的健康材料，与社区合作建立病友互助小组，促进结核病患者家庭整体复原力的提升，进而改善患者的治疗依从性与康复效果。

Abstract: Objective: To examine the trajectory of changes in family resilience levels among tuberculosis patients within 6 months and identify influencing factors. Methods: A longitudinal study followed 148 TB patients at four time points: hospital diagnosis (T1), 1 month (T2), 3 months (T3), and 6 months post-discharge (T4). Data were collected using the Patient General Information Questionnaire, Family Resilience Assessment Scale, Medical Coping Modes Questionnaire, Social Support Rating Scale, and Family APGAR Index. Results: Mean family resilience scores increased gradually from T1 to T4: 98.51 ± 11.15, 100.01 ± 10.00, 100.83 ± 9.57, and 102.18 ± 8.81, respectively. Generalized estimating equations identified ethnicity, marital status, monthly household income, comorbidities, and family care index as significant predictors of resilience trajectories (all P < 0.05). Conclusion: Family resilience among TB patients showed a steady upward trend over six months, reflecting families’ adaptive capacity under disease-related stress. However, disparities linked to sociodemographic and health-related factors warrant targeted interventions—particularly for ethnic minorities, divorced individuals, low-income households, those with comorbidities, and low family care—to enhance resilience, treatment adherence, and recovery outcomes.