幽门螺杆菌感染患者继续动机性访谈对遵医依从性的影响

Effect of continuing motivational interview on compliance of patients with Helicobacter pylori infection

目的探究继续动机性访谈对幽门螺杆菌感染患者遵医依从性。方法选取2013年1月-2016年1月于医院接受治疗的448例幽门螺杆菌感染患者为研究对象,按照随机数表法将患者均分为观察组和对照组,各224例;对照组实施常规幽门螺杆菌感染干预,观察组在对照组基础上加以继续动机性访谈,通过意图前期、意图期、准备阶段、行动阶段以及维持阶段对患者加以干预;干预1、3、6个月后,比较两组患者幽门螺杆菌根除率;采用医院自制的遵医依从性量表对两组患者包括遵医服药次数、服药剂量、间断停药、服药时间、合理饮食、运动锻炼六个维度进行评定;采用自我管理量表对两组患者食物选择、规律锻炼、用药管理、营养监测、进餐方式以及戒烟戒酒等自我管理能力进行比较分析。结果干预1、3、6个月后,观察组幽门螺杆菌根除率分别为18.8%、54.9%和79.0%,对照组分别为9.3%、35.7%和66.5%,两组比较差异有统计学意义(P<0.05);两组患者遵医依从性量表评定结果显示,观察组遵医服药次数、服药剂量、间断停药、服药时间、合理饮食、运动锻炼的依从性均高于对照组,两组比较差异有统计学意义(P<0.05);患者自我管理能力比较结果显示,观察组患者各项自我管理指标水平均高于对照组,两组比较差异有统计学意义(P<0.05)。结论继续动机性访谈能够提高幽门螺杆菌感染患者遵医依从性,对于提高患者幽门螺杆菌根除率、降低患者感染率具有重要意义,可在临床推广应用。

OBJECTIVE To explore the effect of continuing motivational interview on compliance of patients with Helicobacter pylori infection.METHODS A total of 448 patients with H.pylori infection who were treated in our hospital from Jan.2013 to Jan.2016 were selected,and randomly divided into observation group and control group according to the random number table,with 224 cases in each group.In the control group,routine intervention of H.pylori infection was carried out.The observation group was performed continuing motivational interview on the basis of control group,and intervened by the five stages of pre-intention,intention period,preparation phase,action phase and maintenance phase.The eradication rates of H.pylori in the two groups were compared after one month,three months and six months.The self-made compliance scale was used to evaluate the two groups,including the number of medication compliance,medication dose,intermittent withdrawal,medication time,reasonable diet and exercise.Self-management scale was used to analyze the self-management ability of two groups of patients,such as food selection,regular exercise,medication management,nutrition monitoring,eating mode and smoking and drinking.RESULTS The eradication rates of H.pylori infection in observation group were 18.8%,54.9%and 79.0%after 1,3 and 6 months of intervention,and were 9.3%,35.7%and 66.5%in control group,and the difference between the two groups was significant（P〈0.05）.The results of compliance assessment showed that the compliance rates of observing group were significantly higher than those of control group,including the compliance rate of medication,medication dose,intermittent withdrawal,medication time,reasonable diet and exercise,and the differences between the two groups were significant（P〈0.05）.Comparison of self-management ability of patients showed that,the self-management ability of patients in observation group was significantly higher than that of control group（P〈0.05）.CONCLUSION Continuing motivational interview can improve the compliance of patients with H.pylori infection,which is of great significance to improve the eradication rate of H.pylori in patients and reduce the infection rate of patients.It can be widely used in clinical practice.