基于保护动机理论的护理干预对慢性乙肝患者服用核苷类药物依从性的影响

Effect of nursing intervention on nucleoside compliance in patients with chronic hepatitis B based on the theory of protective motivation

目的:探讨基于保护动机理论(PMT)的护理干预对慢性乙肝患者服用核苷类药物治疗依从性的影响。方法:选择2014年3月至2015年3月住院的慢性乙肝患者102例作为研究对象,随机分为干预组50例和对照组52例,对照组给予常规护理,干预组给予基于保护动机理论的护理干预。比较两组干预6、12、18、24个月后服药依从性情况及保护动机评分。结果:出院后6个月和12个月时,对照组和干预组的核苷类药物服药依从率差异无统计学意义(P>0. 05),但在患者出院后的18个月和24个月,干预组的核苷类药物服药依从率高于对照组(P <0. 05);出院后18个月、24个月时干预组严重性、易感性、反应效能及自我效能维度得分高于对照组,而干预组的反应代价维度得分低于对照组(P <0. 05);干预组和对照组在各个时段的内部回报、外部回报得分差异均无统计学意义(P> 0. 05)。结论:基于保护动机理论的护理干预能改善慢性乙肝患者服药依从率,增强患者的保护动机。

Objective： To explore the effect of nursing intervention based on the theory of protective motive on the compliance of nucleoside drugs in patients with chronic hepatitis B. Methods： 102 patients with chronic hepatitis B from March 2014 to March 2015 as the research object,were randomly divided into intervention group（ 50 cases） and control group（ 52 cases）. The control group was given routine care. The intervention group was given nursing intervention based on the protection motive theory. The medication compliance and protective motive score after 6,12,18,24 months between the two groups were compared. Results： There was no statistically significant difference in the compliance rate between the control group and the intervention group at 6 months and 12 months after discharge（ P 〉 0. 05）,but the compliance rate in the intervention group was significantly higher than that in the control group at 18 months and 24 months after discharge（ P 〈 0. 05）. 18 months and 24 months after discharge,the scores of severity,susceptibility,response and self-efficacy of the intervention group were significantly higher than those of the control group,and the reaction cost score was significantly lower than the control group（ P 〈 0. 05）,There was no significant difference between the two groups in the internal returns and the external reward scores（ P 〉 0. 05）. Conclusion： PMT nursing intervention can improve the compliance rate of patients with chronic hepatitis B and enhance the protection motive of patients.