院外随访式延伸护理服务对乙肝肝硬化患者服药依从性及生活质量的影响

Effects of out-of-hospital follow-up extended nursing service on medication compliance and quality of life of patients with hepatitis B cirrhosis

目的将院外随访式延伸护理服务应用于乙肝肝硬化(HBC)患者,分析其对服药依从性及生活质量的影响,旨在为本病防治提供科学依据。方法选取2018-09-01—2020-09-01郑州大学第一附属医院HBC患者91例,根据年龄、性别和病程等因素采用组间平衡原则选择对照组(45例)和观察组(46例)。对照组采取传统护理服务,观察组采取院外随访式延伸护理服务,连续干预3个月。统计2组服药依从性、不良事件发生率,对比2组干预前、干预3个月后心理状态正性负性情绪量表(PANAS)、生活质量简明健康状况量表(SF-36)评分。结果观察组服药依从性好21例、中等22例、差3例,与对照组依从性好12例、中等20例、差13例比较,差异有统计学意义,t=2.470,P=0.014;干预3个月后观察组正性情绪得分为(36.61±4.05)分、精神健康为(58.64±4.13)分、情感职能为(60.03±4.05)分、社会功能为(57.11±3.53)分,高于对照组的正性情绪(28.85±4.18)分、精神健康(54.42±3.37)分、情感职能(54.59±4.48)分、社会功能(52.27±3.49)分,负性情绪得分(22.21±2.55)分低于对照组(26.63±3.85)分,差异有统计学意义,均P<0.05;观察组不良事件发生率8.69%与对照组11.11%比较,差异无统计学意义,P>0.05。结论院外随访式延伸护理服务应用于HBC患者,可提高服药依从性,改善生活质量。

Objective Hepatitis B cirrhosis(HBC)is characterized by a long course of disease,home rehabilitation and low medication compliance.In this study,out-of-hospital follow-up extended care services were applied to HBC patients to analyze their effects on medication compliance and quality of life,in order to provide a scientific basis for the prevention and treatment of HBC.Methods Totally ninety-one patients with HBC in the First Affiliated Hospital of Zhengzhou University were selected from September 1,2018 to September 1,2020.The control group(45 cases)and the observation group(46 cases)were selected according to the balance principle of age,gender and disease course.The control group received traditional nursing services,and the observation group received out-of-hospital follow-up extended nursing services for 3 months.The medication compliance and the incidence of adverse events of the two groups were counted,and the psychological status[positive negative emotion scale(Panas)]and quality of life[concise health status scale(SF-36)]of the two groups before and 3 months after the intervention were compared.Results The proportion of good(21 cases),medium(22 cases),poor(3 cases)medication compliance in the observation group was higher than that in the control group(12 cases,20 cases,13 cases),the difference was statistically significant(t=2.470,P=0.014).Three months after intervention,the scores of positive emotion(36.61±4.05),mental health(58.64±4.13),emotional function(60.03±4.05)and social function(57.11±3.53)in the observation group were higher than those in the control group(28.85±4.18),(54.42±3.37),(54.59±4.48)and(52.27±3.49)points,negative emotion(22.21±2.55)points were lower than the control group(26.63±3.85)points,the difference was statistically significant,P<0.05.The incidence of adverse events in the observation group(8.69%)was compared with the control group(11.11%),the difference was not statistically significant(P>0.05).Conclusion Out-hospital follow-up extended nursing service for HBC patients can improve medication compliance and quality of life.