慢性乙型病毒性肝炎门诊患者复诊依从性及影响因素调查研究

Influencing Factors of Compliance with Return Visit in Chronic Hepatitis B Patients

目的探讨影响慢性乙型病毒性肝炎门诊患者复诊依从性的相关因素。方法通过问卷调查和就诊记录采集患者一般情况、有无纳入随访系统及抗病毒时间等资料,并统计所有患者2年来理论就诊时间间隔与实际就诊时间间隔的差值。复诊依从性=实际就诊时间间隔-理论就诊时间间隔,依从性良好定义为复诊依从性<8周。结果纳入随访系统的患者复诊依从性明显高于未纳入随访系统的患者(P<0.05)。未纳入随访系统的患者中,依从性良好组患者在居住地、文化背景及抗病毒时间与依从性差组比较,差异有统计学意义(P<0.05),但多因素分析未提示显著影响因素。在纳入随访系统的患者中,单因素分析与多因素分析都提示依从性良好组患者与依从性差组患者仅在居住地项目上差异有统计学意义(P<0.05)。结论纳入随访,进行规律依从性教育可以显著提高患者复诊依从性。居住地与就诊医院距离遥远是影响复诊依从性的危险因素,对于这部分患者应加强复诊依从性教育。

Objective To investigate the influencing factors of compliance with return visit in chronic hepatitis B patients. Methods The investigation was conducted and medical records were reviewed for patients ’ demographic data, with or without rolled in follow-up system and the length of antiviral therapy. Compliance with return visit was defined as actual clinical visit interval minus theoretical clinical visit and compliance with return visit less than eight weeks was considered as good compliance. Results Compliance of patients enrolled in follow-up system was significantly higher than those without （ P〈0.05）. For patients not in follow-up system, comparison of residence, educational background and antiviral duration showed statistical significance （ P〈0.05）, but logistic regression analysis found no factors with significant statistical difference. For patients enrolled in follow-up system, the only significant difference was from their residence （P〈0.05）. Conclusion Being enrolled in follow-up system can significantly improve patients’ compliance with return visit. Compliance education should be strengthened for patients living far from the hospital since they always have poor compliance.