探讨机械瓣膜置换术患者服药信念对社会支持与抗凝治疗依从性的中介作用

Mediating effect of belief about medicine on correlation between social support and adherence to anticoagulation treatment among patients with mechanical heart valve replacement

目的探讨机械瓣膜置换术患者社会支持、服药信念和抗凝治疗依从性三者之间的关系以及服药信念在社会支持和抗凝治疗依从性间的中介作用。方法选取154例机械瓣膜置换术患者作为调查对象进行门诊、电话等形式的回访。采用社会支持评定量表、中文版服药信念特异性问卷和抗凝治疗依从性量表。结果本次问卷调查的患者社会支持与服药信念呈明显相关性（r=0．441，P〈0．05），服药信念与抗凝治疗依从性呈正相关（r=0．441，P〈0．05），社会支持与抗凝治疗依从性均有统计学意义（r=0．300，P〈0．05）。将服药信念与社会支持和抗凝治疗依从性进行中介效应检验。检验结果中，在服药信念的中介作用下，社会支持与抗凝治疗依从性之间不存在统计学意义（B=0．020，P〉0．05）。结论服药信念在社会支持与抗凝治疗依从性之间具有完全中介作用。社会支持通过改善服药信念提高患者抗凝服药依从性。

Objective To explore the relationships among social support, belief about medicine and adherence to anticoagulation treatment, and mediating effect of belief about medicine on the relationship between social support and adherence to anticoagulation treatment among patients with mechanical heart valve replacement. Methods Totally 154 patients were recruited. The social support scale, the modified Chinese Version Morisky Medication Adherence Scale（MMAS-8） and belief about medicine scale were used and the information on patients were collected through clinic and telephone interviews. Results The social support was correlated with belief about medicine （r=0.441, P〈0.05）. The belief about medicine was correlated with adherence to anticoagulation treatment （r=0.441, P〈0.05）. The social support was correlated with adherence to antieoagulation treatment （r=0.300, P〈0.05） ~ The mediator effect of the belief about medicine was tested between social support and adherence to anticoagulation treatment. In the result, with the influence of belief about medicine .The social support was not correlated with adherence to anticoagulation treatment （ B=0.020, P 〉 0. 05）. Conclusion Belief about medicine plays a completely mediating role in the relation between social support and adherence to anticoagulation treatment.