机械瓣膜置换术后患者首次抗凝依从性及其影响因素

Adherence to Anticoagulation and Its Influencing Factors in Patients New to Anticoagulation Therapy after Mechanical Heart Valve Replacement

目的评估机械瓣膜置换术后患者首次抗凝依从性,并探讨其影响因素。方法采用一般资料调查表、抗凝依从性问卷及抗凝知识问卷对165例机械瓣膜置换术后的出院患者进行电话回访。结果 165例机械瓣膜置换术后患者首次的抗凝依从性平均得分为(36.44±3.70)分,33.6%的患者抗凝依从性差,抗凝知识平均得分为(13.52±5.86)分;多元逐步回归结果显示,患者的抗凝知识、文化程度、月收入及年龄是抗凝依从性的影响因素,其中抗凝知识对患者抗凝依从性的影响最大。结论机械瓣膜置换术后患者首次抗凝依从性仍有待进一步提高,医护人员应通过更加科学有效的健康教育方式增加患者的抗凝知识,加强对较低文化程度和收入及年轻患者的干预指导以提高其抗凝依从性。

Objective To evaluate patients＇ adherence to anticoagulation therapy after mechanical heart valve replacement and to explore its risk factors in patients new to anticoagulation therapy. Methods Basic information, the adherence to and knowledge of antieoagulation therapy of 165 discharged patients were got through telephone interviews. Results The average score of adherence to anticoagulation therapy and knowledge of new to anticoagulation with warfarin were （36.44±3.70） and （13.52±5.86） respectively. 33.6; had poor adherence. Multiple stepwise regression analysis showed that poor knowledge and lower education and income would lead to poor adherence, of which knowledge is a predominant factor. Conclusion Patients ; adherence to new to anticoagulation with warfarin after mechanical heart valve replacement needs to be improved further. Health care professionals should increase patients; knowledge through more scientific and effective health education, especially for the lower education and income as well as the younger patients, so as to improve patients; adherence to antieoagulation therapy.