中轴型脊柱关节炎患者抗风湿药物服药信念现状及其影响因素

Status and influencing factors of medication beliefs in patients with axial spondyloarthritis

目的调查中轴型脊柱关节炎患者服药信念现状及其影响因素,为改善服药信念制定干预策略提供参考依据。方法采用便利抽样法,选取2020年10月至2021年10月就诊于广州市某三级甲等综合医院的168例中轴型脊柱关节炎患者,采用服药信念问卷(beliefs about medicines questionnaire,BMQ)、服药依从性量表(8-item morisky medication adherence scale,MMAS-8)和疼痛灾难化量表(pain catastrophizing scale,PCS)进行调查。结果157例患者完成研究。服药信念得分中位数为1.00(1.00,3.00)分,服药依从性得分中位数为5.50(4.38,6.50)分。单因素分析结果显示,病程5年以下的患者服药信念更低(Z=-3.111,P=0.002),服药信念得分与服药依从性总分(r=0.294,P<0.001)、文化程度(r=0.162,P=0.042)呈正相关,与疼痛灾难化量表总分呈负相关(r=-0.157,P=0.050)。多因素分析结果显示,病程、文化程度和服药依从性进入多重线性回归方程(F=11.238,R^(2)=0.181,P<0.001)。结论中轴型脊柱关节炎患者服药信念处于较低水平,有待改善,其受服药依从性、病程和文化程度影响,可针对影响因素开展健康教育和干预,以改善患者服药信念。

Objective To explore the status and influencing factors of medication beliefs in patients with axial spondyloarthritis(axSpA)so as to provide reference for establishment of measures to improve medication beliefs.Methods One hundred and sixty-eight patients with axSpA were recruited from a general hospital in Guangzhou from October 2020 to October 2021 by convenience sampling.The patients were surveyed using the beliefs about medicines questionnaire(BMQ),8-item Morisky medication adherence scale(MMAS-8)and pain catastrophizing scale(PCS).Results A total of 157 patients completed the study.The score of beliefs about medicines was 1.00(1.00,3.00),and the score of medication adherence was 5.50(4.38,6.50).The patients with duration of disease less than 5 years had lower medication beliefs(Z=-3.111,P=0.002).The medication beliefs were positively correlated with medication adherence score(r=0.294,P<0.001)and educational level(r=0.162,P=0.042),and negatively correlated with the score of pain catastrophizing scale(r=-0.157,P=0.050).Multiple linear regression analysis showed that the influencing factors of medication beliefs were disease duration,educational level,and medication adherence(F=11.238,R^(2)=0.181,P<0.001).Conclusions The beliefs about medicines of axSpA patients are low and need to be enhanced.The medication beliefs are affected by medication adherence,disease duration and educational level.Health education and interventions targeting the influencing factors are required to improve the medication beliefs.