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预防医学  2023, Vol. 35 Issue (11): 966-969,974    DOI: 10.19485/j.cnki.issn2096-5087.2023.11.011
  疾病控制 本期目录 | 过刊浏览 | 高级检索 |
慢性乙型肝炎患者服药依从性调查
罗发燕, 陈铁霞, 罗平平, 诸伟红
浙江大学医学院附属杭州市第一人民医院感染科,浙江 杭州 310006
Medication adherence among patients with chronic hepatitis B
LUO Fayan, CHEN Tiexia, LUO Pingping, ZHU Weihong
Department of Infection, Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, Zhejiang 310006, China
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摘要 目的 了解慢性乙型肝炎(CHB)患者对核苷(酸)类似物抗病毒药物治疗的服药依从性,为提高CHB患者服药依从性提供参考。方法 选择2021年6月—2022年12月在浙江大学医学院附属杭州市第一人民医院治疗的18~44岁CHB患者为调查对象,收集患者人口学信息和临床资料;采用Morisky服药依从性量表评估服药依从性;采用简易疾病感知问卷评估对疾病的负性感知;采用社会支持评定量表评估社会支持水平;采用多因素logistic回归模型分析服药依从性的影响因素。结果 发放问卷225份,回收有效问卷210份,问卷有效率为93.33%。CHB患者年龄为(35.94±8.72)岁。男性119例,占56.67%;女性91例,占43.33%。疾病感知得分为(44.09±12.06)分。检出Morisky服药依从性良好149例,占70.95%,依从性差61例,占29.05%。多因素logistic回归分析结果显示,大专及以上学历(OR=1.676,95%CI:1.105~2.910)、家庭人均月收入>5 000元(OR=2.518,95%CI:1.360~5.033)、接受过CHB健康教育(OR=3.590,95%CI:1.611~7.932)、社会支持水平(高,OR=3.202,95%CI:1.613~5.870;中等,OR=1.267,95%CI:1.085~2.409)是CHB患者服药依从性的的促进因素;服药种类>3种(OR=0.388,95%CI:0.204~0.526)、高疾病感知得分(OR=0.601,95%CI:0.395~0.808)是CHB患者服药依从性的制约因素。结论 CHB患者服药依从性受文化程度、家庭人均月收入、服药种类、疾病感知得分、接受过CHB健康教育和社会支持水平等因素影响。临床可针对以上因素制定个体化干预策略,提高患者服药依从性。
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罗发燕
陈铁霞
罗平平
诸伟红
关键词 慢性乙型肝炎抗病毒治疗服药依从性影响因素    
AbstractObjective To identify the factors affecting the adherence to administration of nucleoside/nucleotide analogues among patients with chronic hepatitis B (CHB), so as to provide insights into improving medication adherence among CHB patients. Methods CHB patients at ages of 18 to 44 years that underwent treatment in Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine from June 2021 to December 2022 were enrolled, and subjects' demographic and clinical characteristics were collected. The medication adherence was evaluated with the Morisky Medication Adherence Scale, and the negative illness perception was evaluated using the simplified Illness Perception Questionnaire, while the social support level was evaluated with the Social Support Scale. In addition, factors affecting the medical adherence were identified using a multivariable logistic regression model among CHB patients. Results A total of 225 questionnaires were allocated and 210 valid questionnaires were recovered, with an effective recovery rate of 93.33%. The respondents had a mean age of (35.94±8.72) years, and included 119 men (56.67%) and 91 women (43.33%), with a mean total illness perception score of (44.09±12.06) points. Morisky Medication Adherence Scale classified good in 149 cases (70.95%) and poor in 61 cases (29.05%). Multivariable logistic regression analysis identified an educational level of college degree and above (OR=1.676, 95%CI: 1.105-2.910), family monthly per capita income of >5 000 Yuan (OR=2.518, 95%CI: 1.360-5.033), receiving health education pertaining to CHB (OR=3.590, 95%CI: 1.611- 7.932), high or medium level of social support (high: OR=3.202, 95%CI: 1.613-5.870; medium: OR=1.267, 95%CI: 1.085-2.409) as factors improving the medication adherence, and administration of more than 3 types of drugs (OR=0.388, 95%CI: 0.204-0.526) and high illness perception score (OR=0.601, 95%CI: 0.395-0.808) as factors constraining medication adherence among CHB patients. Conclusions The medication adherence are affected by educational level, family monthly per capita income, types of drugs, illness perception score, health education pertaining to CHB and social support level among CHB patients. Individualized intervention strategy is required targeting these influencing factors to improve the medication adherence among CHB patients.
Key wordschronic hepatitis B    antiviral therapy    medication adherence    influencing factor
收稿日期: 2023-07-24      修回日期: 2023-09-30      出版日期: 2023-11-10
中图分类号:  R512.6  
通信作者: 诸伟红,E-mail:1392506978@qq.com   
作者简介: 罗发燕,本科,护师,主要从事感染性疾病健康教育工作
引用本文:   
罗发燕, 陈铁霞, 罗平平, 诸伟红. 慢性乙型肝炎患者服药依从性调查[J]. 预防医学, 2023, 35(11): 966-969,974.
LUO Fayan, CHEN Tiexia, LUO Pingping, ZHU Weihong. Medication adherence among patients with chronic hepatitis B. Preventive Medicine, 2023, 35(11): 966-969,974.
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http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2023.11.011      或      http://www.zjyfyxzz.com/CN/Y2023/V35/I11/966
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