以微信平台为媒介的延续护理干预对慢性乙型肝炎患者口服核苷（酸）类似物依从性的影响

Effects of continuous nursing intervention on WeChat on the compliance of oral nucleoside （acid） analogues in patients with chronic hepatitis B

目的 借助微信平台媒介对慢性乙型肝炎患者进行延续护理干预,研究分析该干预方式对慢性乙肝患者口服核苷（酸）类似物（NA）依从性的影响.方法 选取2014年10月—2016年12月在四川省广元市第三人民医院治疗的240例慢性乙肝患者,根据护理方式不同分为试验组120例（建立专业的微信护理团队及相关微信群,给予慢性乙肝患者提供咨询、权威的科学诊断信息、预约挂号等延续护理干预6个月）,对照组120例（使用常规护理方式）,所有患者给予口服NA治疗,观察比较两组患者干预后6个月的依从性评分、出院后1、3、6个月的复查率及出院后12个月的复发率.结果 干预后对照组患者依从性评分为（52.37±7.65）分,试验组为（63.85±8.57）分,差异有统计学意义（t=10.947,P〈0.05）;试验组经干预后高依从性患者51例,高于对照组的29例,差异有统计学意义（χ^2=9.075,P〈0.05）;试验组患者出院后1、3、6个月的复查率均为100.00％,高于对照组的96.67％、92.50％、82.50％,试验组出院后12个月的复发率为8.33％,低于对照组的20.00％,差异均有统计学意义（P〈0.05）.结论 借助微信平台媒介对慢性乙型肝炎患者进行延续护理,能够明显提高患者口服NA的依从性,提高复诊配合度,减少术后1年的复发率.

Objective Continuous nursing intervention was conducted in patients with chronic hepatitis B by means of Weixin platform. The effect of this intervention on compliance of oral nucleoside （acid） analogues （NA） in patients with chronic hepatitis B was studied and analyzed.Methods A total of 240 patients with chronic hepatitis B treated in the Third People＇s Hospital of Guangyuan in Sichuan Province from October 2014 to December 2016 were recruited. According to the different nursing methods, all the research subjects were divided into experimental group （n=120） and control group （n=120）. For the experimental group, a nursing WeChat team and related WeChat group was established to provide professional counseling, authoritative scientific diagnostic information, appointment registration and other continuous nursing intervention for 6 months. Patients in the control group were given routine nursing. All patients were given oral NA treatment. The score of compliance after 6 months＇ intervention, the rate of review at 1st, 3rd and 6th month after discharge, and the recurrence rate at 12th month after discharge.Results The score of compliance of the control group was （52.37±7.65）, and experimental group （63.85±8.57） after intervention. The difference in compliance was statistically significant （t=10.947,P〈0.05）. After intervention, the number of high compliance patients was 51 in the experimental group, which was higher than 29 in the control group, and the difference was statistically significant （χ^2=9.075,P〈0.05）. The rates of review at 1st, 3rd and 6th month after discharge of the experimental group were all 100.00%, which were higher than those of the control group （96.67%, 92.50% and 82.50%）. The recurrence rate at 12th month after discharge of the experimental group was 8.33%,which was lower than 20.00% of the control group, and the difference was statistically significant （P〈0.05）. Conclusions With the help of WeChat platform, continuous nursing can significantly improve the compliance of oral NA, improve the degree of re-visit and reduce the recurrence rate after 1 years in patients with hepatitis B.