云南省炎症性肠病患者药物依从性及疾病知识现状的调查

发布时间：2018-05-26 01:02

本文选题：炎症性肠病 + 溃疡性结肠炎　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]1.调查云南省炎症性肠病患者药物依从性及患者对疾病知识掌握现状;2.明确炎症性肠病患者药物依从性及疾病知识的影响因素。[方法]选取2015年1月1日至2017年1月1日在云南省昆明医科大学第一附属医院消化内科诊断明确的145例炎症性肠病患者,运用一般资料问卷、Morisky药物依从性量表(MMAS-8)、中文版克罗恩病与结肠炎知识问卷(CCKNOW)进行调查并收集相关资料,数据用SPSS21.0软件进行统计分析,经t检验、方差分析、卡方检验及线性回归分析分析IBD患者药物依从性、疾病知识现况及其相关影响因素。[结果]1.138例患者完成问卷调查,其中男性86例(62.3%),女性52例(37.7%)。平均年龄42.71 ±15.66岁,最小年龄为14岁,最大年龄为80岁,溃疡性结肠炎100例(72.5%),克罗恩病患者38例(27.5%)。调查所示,MMAS总得分为4.47±1.44(1.25～7.75)分,其中UC患者MMAS得分为4.38±1.34分,低于CD患者依从性得分4.70±1.66分,但统计假设未达显著水平(P=0.244),尚不能认为UC患者的药物依从性比CD患者低。119例患者依从性差,占86.2%,其中UC患者89例(89.0%),CD患者30例(78.9%);17例患者依从性中等,占12.3%,其中UC患者10例(10.0%),CD患者7例(18.4%);2例患者依从性好,占1.4%,其中 UC 患者 1 例(1.0%),CD 患者 1 例(2.6%)。2.IBD患者MMAS评分与婚姻状况(P=0.033)、文化程度(P=0.044)、学生状态(P=0.049)、用药方案是否清楚(P=0.016)、服用激素(P=0.020)相关。与性别、年龄、民族、生育状况、居住状况、就业状态、年收入、医疗付费方式、吸烟、饮酒无关。3.138例IBD患者CCKNOW平均总得分为9.23±4.65(0～21)分,其中,UC患者CCKNOW平均总得分为8.81±4.66分,CD患者为10.34±4.50分,但统计假设未达到显著水平(P=0.084),尚不能认为UC患者的疾病知识掌握低于CD患者。4.IBD患者CCKNOW得分与婚姻状况(P=0.009)、生育状况(P=0.014)、文化程度(P=0.000)、就业状态(P=0.020)、用药方案是否清楚(P=0.003)、服用激素(P=0.023)、医疗付费方式(P=0.025)、胃肠道手术(P=0.027)相关。与性别、年龄、民族、居住状况、年收入、吸烟、饮酒无关。5.患者MMAS评分与其自身的CCKNOW得分呈正相关。[结论]1.云南省炎症性肠病患者的药物依从性现状不容乐观,患者药物依从性与婚姻状况、文化程度、学生状态、用药方案是否清楚、服用激素密切相关。消化科医生应在患者药物治疗过程中关注和管理患者用药行为,实时评估并加以干预。2.云南省炎症性肠病患者疾病知识掌握现状整体不佳,患者的疾病知识与婚姻状况、生育状况、文化程度、就业状态、用药方案是否清楚、服用激素、医疗付费方式、有无胃肠道手术史相关。3.疾病相关知识对患者药物依从性有较大的影响,提高患者疾病相关知识水平,加强患者健康教育及自我管理,可以提高患者药物依从性从而改善患者的健康相关生活质量。
[Abstract]:[objective] 1. To investigate the drug compliance and knowledge of inflammatory bowel disease patients in Yunnan Province. To determine the drug compliance and disease knowledge of inflammatory bowel disease patients. [methods] 145 patients with inflammatory bowel disease were selected from January 1, 2015 to January 1, 2017 in the Department of Gastroenterology, the first affiliated Hospital of Kunming Medical University of Yunnan Province. The Morisky drug compliance scale (MMAS-8A) and the Chinese version of CCKNOW (knowledge questionnaire on Crohn's Disease and Colitis) were used to investigate and collect relevant data. The data were statistically analyzed by SPSS21.0 software, and analyzed by t-test and ANOVA. Chi-square test and linear regression analysis of drug compliance, disease knowledge and related factors in patients with IBD. [results] A questionnaire survey was completed in 1.138 patients, of whom 86 were male (62.3%) and 52 were female (37. 7%). The average age was 42.71 卤15.66 years old, the minimum age was 14 years old, the maximum age was 80 years old. There were 100 cases of ulcerative colitis and 72.5%, 38 cases of Crohn's disease. The total score of MMAs was 4.47 卤1.44 卤1.257.75). The MMAS score of UC patients was 4.38 卤1.34, which was lower than that of CD patients (4.70 卤1.66), but the statistical hypothesis was not significant (P < 0.244). The drug compliance of UC patients was lower than that of CD patients. Among them, 89 patients with UC and 30 patients with CD with 78.9% had moderate compliance, accounting for 12.3%. Among them, 10 patients with UC had 10 cases with 10.0 CD and 7 patients with 18. 4% CD, and 2 patients had good compliance. Among them, 1 case with UC and 1 case with CD were related to marital status (P < 0.033), education level (P < 0.044), student status (P < 0.049), drug regimen (P < 0.016) and steroid (P 0.020). The average total CCKNOW score of IBD patients was 9.23 卤4.650.21, compared with sex, age, nationality, fertility, living status, employment status, annual income, medical payment, smoking and drinking. The average total CCKNOW score of UC patients was 8.81 卤4.66 and that of CD patients was 10.34 卤4.50. However, the statistical hypothesis does not reach the significant level of P0. 084, it can not be considered that the disease knowledge of UC patients is lower than that of CD patients. 4. The CCKNOW score and marital status of patients with IBD are lower than that of patients with CD, the fertility status is 0. 014%, the education level is 0. 000%, the employment status is 0. 020%, whether the medication plan is clear P0. 003 or not. It is related to the use of the hormone P0. 023, the way of paying for medical treatment is 0. 025, and the gastrointestinal operation is P0. 027). It has nothing to do with sex, age, nationality, living condition, annual income, smoking and drinking. There was a positive correlation between MMAS score and CCKNOW score. [conclusion] 1. The current status of drug compliance in patients with inflammatory bowel disease in Yunnan Province is not optimistic. Drug compliance is closely related to marital status, education level, student status, drug use plan and hormone use. The digestive doctor should pay attention to and manage the behavior of the patient in the course of drug treatment, evaluate and intervene. 2. 2. The status quo of disease knowledge in patients with inflammatory bowel disease in Yunnan Province is not good. The patients' disease knowledge and marital status, fertility status, education, employment status, drug use plan, taking hormones, and paying for medical treatment are clear. There is no history of gastrointestinal surgery. Disease related knowledge has great influence on patients' drug compliance. Improving patients' disease related knowledge, strengthening patients' health education and self-management can improve patients' drug compliance and improve patients' health-related quality of life.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R574

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