个体化疾病管理干预对肝硬化失代偿期患者服药信念和依从性的影响

Effect of individualized disease management intervention on the medication beliefs and complianceamong patients with decompensated cirrhosis

目的 评估个体化疾病管理干预对肝硬化失代偿期患者服药信念和依从性的影响。方法 选择江苏省无锡市第二人民医院消化内科2016 年6 月—2017 年4 月肝硬化失代偿期患者64 例，随机分为干预组和对照组，每组32 例。干预组采用个体化疾病管理干预方法，对照组采用常规治疗护理及随访。采用服药信念特异性问卷（BMQ）和Morisky 用药依从性问卷（MMAS）分别在干预前、干预 3 个月后进行评估，比较两组干预效果。结果 干预3 个月后，干预组患者BMQ（13.23±4.67）分、MMAS （7.38±1.86）分，较干预前提高，差异有统计学意义（t值分别为4.213、5.050；P＜ 0.05）。干预后，对照组患者BMQ（10.48±4.32）分、MMAS（5.78±2.01）分，均低于干预组，两组比较差异有统计学意义（t值分别为2.445、3.305；P＜ 0.05）。结论 个体化疾病管理干预能够提高肝硬化失代偿期患者服药信念，改善其服药依从性。

Objective To evaluate the effect of individualized disease management intervention on the medication beliefs and compliance among patients with decompensated cirrhosis. Methods A total of 64 patients with decompensated cirrhosis in Department of Gastroenterology in Wuxi No.2 People＇s Hospital from June 2016 to April 2017 were randomly divided into the intervention group and the control group, 32 cases respectively. Patients in the intervention group received individualized disease management, while patients in the control group received conventional treatment, nursing and follow-up. The Belief about Medicines Questionnaire-Specific（ BMQ） and the Morisky Medication Adherence Scale（ MMAS） were used to compare the interventional effect between two groups before and three months after the intervention. Results Three months after the intervention, BMQ（ 13.23±4.67） and MMAS（ 7.38±1.86） scores in the intervention group were significantly higher than those before the intervention（ t=4.213, 5.050; P〈 0.05）. After the intervention, scores of BMQ（ 10.48±4.32） and MMAS（ 5.78±2.01） in the control group were significantly lower than those in the intervention group（ t=2.445, 3.305; P〈 0.05）. Conclusions Individualized disease management intervention can improve the medication beliefs and compliance of patients with decompensated liver cirrhosis.