健康教育对肾移植术后患者服药依从性的作用

Effect of healthy education on improving the drug compliance of patients after renal transplantation

目的:肾移植患者对免疫抑制药物的依从性与排斥反应的发生及移植肾的存活等临床结果有关,调查健康教育对提高肾移植术后患者服药依从性的影响。方法:选择2005-01/2006-12在解放军总医院接受肾移植手术患者124例,患者对治疗方案均知情同意。按随机数字表法分为健康教育组和对照组,每组各62例。对照组进行常规护理,健康教育组在常规护理基础上实施健康教育干预措施,然后进行包括一般情况、肾病、肾移植和服药依从性在内的问卷调查,比较两组患者得分情况,得分越高,表明对肾移植相关知识掌握越多,服药依从性越好。结果:124例肾移植患者全部进入结果分析。①服药依从性在不同年龄组之间差异无显著性意义(P>0.05);女性患者的依从性较男性好(P<0.01);不同文化程度、婚姻状况、医疗费支付方式的患者依从性差异无显著性意义(P>0.05);干部较其他职业者依从性好(P<0.05);服用的主要免疫抑制剂为进口药物者较国产者依从性好(P<0.01);有提醒服药者较无提醒服药者依从性好(P<0.01)。②健康教育组患者实施健康教育干预后对肾移植术基本知识的掌握和认识程度及服药依从性的得分均显著高于对照组(P<0.05)。结论:系统规范的健康教育可使患者掌握肾移植的基本知识,增强患者的服药依从性,有助于提高其生活质量。

AIM： The compliance of administrating immunosuppressive drugs in patients following renal transplantation is related to the occurrence of rejection reaction and the survival of transplanted kidney. This study is designed to investigate the effect of improving the drug compliance of the patients after renal transplantation by the healthy education. METHODS： From January 2005 to December 2006, a total of 124 patients underwent renal transplantation in the General Hospital of Chinese PLA were adopted in the study, and were randomly divided into experimental group and control group, 62 cases in each group. Informed consents were obtained from all the patients. The control cases received normal nursing, while the experimental cases gained an intervention study of healthy-educating based on the normal nursing. Then a general questionnaire was performed, including the patient＇s normal conditions, nephropathy, renal transplantation and administration. Finally, the total score of the two groups was compared. The higher scores indicated the more knowledge referring to renal transplantation and the better drug compliance. RESULTS： All the 124 patients were involved in the result analysis.（1）The drug compliance was better in female patients, cadres, those taking imported immunosuppressive drugs and those with medicine reminder than in male, other occupationals, those taking domestic drugs and those without medicine reminder （P 〈 0.01, 0.05）. There were no significant differences among patients of different ages, education backgrounds, marriage conditions and ways of paying medical cost （P 〉 0.05）. （2） The scores of the knowledge comprehension and the drug compliance after renal transplantation in the experimental group was significant higher in the control group after the healthy education （P 〈 0.05）. CONCLUSION： Systematic and standard healthy education can make the patients master the elementary knowledge of the renal transplantation, enhance the drug compliance of the patients, and conduce to improve the quality of life.