罗伊适应模式对外伤性癫痫患者遵医行为及服药依从性的影响

Effects of Roy Adaptation Model on compliance behavior and medication compliance in patients with traumatic epilepsy

目的探讨罗伊适应模式对外伤性癫痫患者遵医行为及服药依从性的影响。方法选取2015年1月至2017年1月在哈尔滨医科大学附属第一医院诊治的外伤性癫痫患者84例作为研究对象。根据随机性原则抽签分为观察组与对照组，各42例。所有患者均口服拉莫三嗪和丙戊酸钠片治疗，治疗观察时间为3个月；对照组在治疗期间给予常规护理，观察组在对照组护理的基础上给予罗伊适应模式干预。比较2组患者的疗效、不良反应情况、遵医行为评分及服药依从性。结果观察组与对照组的总有效率分别为95．2％（40／42）和81．0％（34／42），观察组的总有效率明显高于对照组，差异有统计学意义（P〈0．05）。治疗期间观察组头痛、嗜睡、恶心、食欲下降等不良反应发生率为9．5％（4／42），对照组为38．1％（16／42），观察组的不良反应发生率明显低于对照组，差异有统计学意义（P〈0．05）。在行为锻炼、认知性症状管理及与医师交流等遵医行为方面，观察组得分明显高于对照组，差异有统计学意义[（18．56±8．11）分比（16．52±2．51）分、（8．19±0．25）分比（7．11±2．63）分、（8．45±0．44）分比（7．80±0．10）分]（P〈0．05）。观察组治疗期间服药依从性为100．0％（42／42），明显高于对照组的85．7％（36／42），差异有统计学意义（P〈0．05）。结论罗伊适应模式在外伤性癫痫患者长期药物治疗过程中的应用能提高患者的遵医行为及服药依从性，减少药物不良反应的发生，从而提高治疗效果。

Objective To explore effects of Roy Adaptation Model on compliance behavior and medication compliance in patients with traumatic epilepsy. Methods Eighty-four patients with traumatic epilepsy from January 2015 to January 2017 in the First Affiliated Hospital of Harbin Medical University were randomly divided into observation group and control group, with 42 cases in each group. All patients took lamotrigine and sodium valproate tablets for 3 months. The control group received routine nursing care during treatment; the observation group had nursing intervention based on Roy Adaptation Model. Curative effect, adverse reaction rate, compliance behavior scores and medication compliance rate were analyzed. Results The total effective rate in observation group was significantly higher than that in control group [ 95.2% （40/42） vs 81.0% （34/42）] （P 〈 0. 05 ）. Incidences of headache, drowsiness, nausea and anorexia during treatment in observation group were significantly lower than those in control group [ 9. 5% （ 4/42 ） vs 38.1% （ 16/42 ） ] （ P 〈 0.05 ）. Scores of behavior training, cognitive symptom management and communication with doctors in observation group were significantly higher than those in control group [ （ 18. 56 ± 8.11 ） scores vs （ 16. 52 ± 2. 51 ） scores, （ 8.19 ± 0. 25 ） scores vs （7. 11 ± 2. 63） scores, （8.45 ± 0. 44 ） scores vs （ 7.80 ± 0. 10） scores ] （ P 〈 0. 05 ）. The medication compliance rate in observation group was significantly higher than in control group[ 100% （42/42） vs 85.7% （36/42） ] （P 〈 0. 05 ）. Conclusion The application of Roy Adaptation Model helps improve compliance behavior and medication compliance in traumatic epileptic patients during long-term drug treatment and enhance the therapeutic effect.