老年心房颤动患者抗凝服药依从性及其影响因素分析

Compliance with Anticoagulant Medication and Its Influencing Factors in Elderly Patients with Atrial Fibrillation

目的探讨老年心房颤动患者抗凝服药依从性的影响因素。方法采用便利抽样法,运用自制一般资料问卷和中文修订版Morisky服药依从性量表和慢性病自我效能量表,于2019年3—8月对上海市第六人民医院心血管内科的118例老年心房颤动抗凝患者进行调查。结果老年心房颤动患者抗凝服药高度依从为35例(33.3%),出院后2周自我效能得分(7.51±1.72)分,抗凝服药依从性与自我效能呈正相关(r=0.505,P<0.01)。文化程度、收入水平、是否医保患者和既往住院次数是抗凝服药依从性的主要影响因素,差异具有统计学意义(P<0.05)。结论老年心房颤动患者抗凝服药依从性较差,自我效能越高其依从性越好,需高度重视低文化水平、低收入、非医保和既往入院次数较少的患者。

Objective To explore the influencing factors for compliance with anticoagulant medication in elderly patients with atrial fibrillation.Methods 118 elderly anticoagulant patients with atrial fibrillation in Cardiology Department of Shanghai Sixth People’s Hospital from March to August in 2019 were enrolled and investigated by convenience sampling method,self-made general data questionnaire and Chinese revised MMAS-8 Chronic Disease Self-Efficacy Scale.Results Within the elderly patients with atrial fibrillation,35 cases(33.3%)manifested as high compliance with anticoagulant therapy.The self-efficacy score after discharge for 2 weeks was 7.51±1.72.The compliance with anticoagulant medication was positively correlated with self-efficacy(r=0.505,P<0.01).The educational level,income level,medical insurance and frequency of previous hospitalizations were the main influencing factors for compliance with anticoagulant medication,and the differences were statistically significant(P<0.05).Conclusion The elderly patients with atrial fibrillation have poor compliance with anticoagulant medication,which will be increased with the elevation of self-efficacy.The patients with low education and income level,nonmedical insurance and fewer hospitalizations need special attention.