动机性访谈对成年哮喘患者用药依从性及哮喘控制水平的影响

Effects of motivational interview on medication adherence and control level of asthma in adult patients with asthma

目的探讨基于动机性访谈的健康教育对哮喘患者用药依从性及哮喘控制水平的影响。方法采用便利抽样法，选取2016年1—12月在上海市普陀区人民医院呼吸科就诊的100例哮喘住院患者作为研究对象。按随机数字表法分为对照组和观察组各50例，观察组2例因个人原因中途退出，48例完成干预；对照组2例因中途病情变化而脱落，1例因个人原因中途退出，47例完成干预。对照组患者接受常规健康教育，观察组患者接受基于动机性访谈的健康教育，采用中文版哮喘用药依从性量表（MARS-A）、哮喘控制测试（ACT）问卷于干预前、干预1、2、3个月后评价患者的用药依从性、哮喘控制水平。结果干预前两组患者用药依从性好的患者比例均为0%，干预1、2、3个月后，观察组依从性均优于对照组，差异均有统计学意义（P〈0.05）。干预前两组的哮喘控制水平差异无统计学意义（P〉0.05），重复测量方差分析发现两组患者哮喘控制得分干预主效应、时间主效应均有统计学意义（P〈0.05），哮喘控制得分的干预因素和时间因素存在交互作用（P〈0.05）。结论基于动机性访谈的健康教育可有效提高哮喘患者用药依从性及改善哮喘控制水平。

ObjectiveTo explore the effects of the motivational interview on medication adherence and control level of asthma in adult patients with asthma.MethodsA total of 100 asthma patients who were hospitalized in the Respiration Department of Putuo People＇s Hospital in 2016 were selected in the study using convenience sampling. According to the random number table, the participants were divided into the observation group （n=50） and the control group （n=50） . Two cases from the observation group withdrew from the study due to personal reasons, leaving 48 patients in the observation group. Three cases from the control group withdrew from the study （i.e. two for disease changes and one for personal reasons） , leaving 47 cases in the control group. The control group received conventional health education while the observation group received education based on motivational interview. The asthma medication compliance scale （Chinese version） （MARS-A） and asthma control test （ACT） questionnaire were used to evaluate the medication compliance and asthma control level before the intervention and 1, 2 and 3 months after the intervention.ResultsNone of the patients had good medication compliance before the intervention. However, patients in the observation group had significantly better adherence at 1, 2, and 3 months after the intervention compared with the control group （P〈0.05） . There were no significant differences in asthma control level between two groups before intervention （P〉0.05） . But after the intervention, the repeated variance analysis showed that there were significant differences in both intervention effect and time effect for asthma control score, and the interaction effects existed between intervention and time （P〈0.05） .ConclusionsThe health education based on motivational interview can effectively improve the medication adherence and the control level of asthma in adult patients with asthma.