乙型肝炎肝硬化患者自我健康管理水平及其影响因素

Factors that affect the self-health management ability of patients with liver cirrhosis in association with hepatitis B

目的探讨乙型肝炎肝硬化患者自我健康管理水平及其影响因素。方法采用一般情况调查表、肝硬化患者自我管理行为量表、社会支持量表、医学应对方式问卷对196例乙型肝炎肝硬化患者进行调查,通过单因素及多因素Logistic回归分析影响肝硬化患者自我健康管理水平的相关因素。结果 196例乙型肝炎肝硬化患者的自我健康管理得分为51.08±8.33分。单因素分析显示:不同性别、婚姻状态、月均收入、病程、睡眠状况、应对方式、社会支持的乙型肝炎肝硬化患者的自我健康管理评分比较,差异均有统计学意义(P<0.05)。Logistic回归分析显示:性别(男性)(OR=0.724)、病程<3年(OR=0.916)、应对方式(屈服)(OR=0.985)是患者自我健康管理水平的阻碍因素(P<0.05);婚姻状态(在婚)(OR=1.029)、睡眠状况(无失眠)(OR=2.053)、高水平社会支持(OR=3.016)是患者自我健康管理水平的促进因素(P<0.05)。结论乙型肝炎肝硬化患者自我健康管理水平有待提高,应注重加强男性、消极应对的乙型肝炎肝硬化患者的健康教育,并重视充分利用家庭、社会支持系统提升其自我健康管理水平。

Objective To identify the factors that affect the self-health management ability of patients suffering liver cirrhosis in association with hepatitis B. Methods Firstly, 196 patients were chosen as the subjects of a survey conducted by means of General Demographic Information, Self-management Behaviour Score,Social Support Score, and Medical Treatment Method Questionnaire for patients of liver cirrhosis, Secondly, univariate analysis and multivariate logistic regression analysis were conducted to determine the factors that affect the self-health management ability of the subjects. Results The average score which the 196 subjects achieved on self-health management was 51.08 ±8.33. Univariate analysis showed that patients different in gender, marital status, economic status, course of disease, sleep status, marital status, coping style and social support achieved different scores on self-health management. The differences as observed from comparison therein were statistically significant(P<0.05). Multivariate logistic regression analysis showed that gender(male)(OR=0.724), duration of illness<3 years(OR=0.916), coping style(surrender)(OR=0.985) were the factors that negatively affected the self-health management ability of the patients. Marital status(married)(OR=1.029), sleep status(insomnia free)(OR=2.053), and high level of social support(OR=3.016) were the factors that contribute to improvement of the self-health management ability of the subjects(P<0.05). Conclusions The level of self-health management ability of patients of liver cirrhosis in association with hepatitis B needs to be improved. More attention should be paid to male patients of liver cirrhosis and those who cope with diseases in a negative and passive manner in providing health education to them. Family support and social support should also be mobilized for the patients in their efforts to manage themselves.