冠脉介入治疗术后患者用药依从性、自我管理现状及其影响因素研究

Study on medication adherence,self-management status and its influencing factors after percutaneous coronary intervention

目的研究冠脉介入治疗术后患者用药依从性、自我管理现状及其影响因素。方法采用Morisky-Green测评表对180例支架植入术后8~12个月内患者进行调查,了解患者冠脉介入术后的用药依从性;运用冠心病自我管理行为量表、心理问题筛查问卷、自我管理知识问卷和一般资料调查表,对该患者进行调查,了解该患者的自我管理现状及其影响因素。结果患者用药依从性均较出院时有所降低,其中对氯比格雷的依从性最高（100.00%）,而对ACEI/ARB依从性最低（84.44%）。该患者的管理行为量表得分为（80.46±12.10）分,总得分率为59.65%。多因素分析显示自我管理知识、年龄、疾病医学管理知识、文化程度、收入水平、情绪管理知识、是否高特质怒人群以及是否焦虑等因素影响患者的自我管理行为。结论经皮冠状动脉支架植入术后患者用药依从性不理想,患者的自我管理行为处于较低水平,需要临床医生及患者共同关注并努力提高。

Objective To study the patients＇ medication compliance and self-management status and its influencing factors after the coronary artery intervention surgery. Methods The Morisky-Green evaluation form was used to investi- gate 180 patients in the 8th to 12th month after the stent implantation surgery in order to understand their medication compliance after the coronary artery intervention surgery. The self-management behavior scale, psychological problems screening questionnaire, self-management knowledge questionnaire and general information questionnaire for coronary heart disease were used to investigate the patients in order to understand their self-management status and its influenc- ing factors. Results The patients＇ medication compliance all reduced compared to that at discharge from hospital, of which the compliance to clopidogrel was the highest （100.00%） and the compliance to ACEI/ARB was the lowest （84.44%）. The patients＇ management behavior scale score was （80.46±12.10） points and the total scoring rate was 59.65%. Multivariate analysis showed that self-management knowledge, age, medical management knowledge of dis- eases, educational level, income level, emotion management level, whether high trait anger population or not and whether anxious or not were influencing factors of the patients＇ self-management behavior. Conclusion After the per- cutaneous coronary stent implantation surgery, the patients＇ medication compliance is not ideal and their self-manage- ment behavior is at a low level, so clinicians and patients need to pay joint attention and endeavor to improve.