摘要
目的:探讨动机性访谈(Motivational Interview,MI)对冠心病支架植入患者危险因素控制及服药依从性的影响。方法:采用随机数字表法抽取符合纳入标准的160例患者,随机将其分为对照组和动机组,每组80例。动机组采用MI对患者进行院内及院外随访,内容围绕冠心病危险因素控制及服药依从性,从访谈中发现患者生活方式及用药方式存在的问题,并与患者协同制定解决方案;对照组给予目前公认的改善PCI术后患者依从性的方法,入院时和出院后6个月,分别采用危险因素调查表及服药依从性调查表对两组患者危险因素控制情况及服药依从性进行评估。结果:Logistic回归结果显示,性别、收入、学历、糖尿病、高脂血症、高血压、吸烟、运动和BMI指数是造成冠心病患者服药依从性差的主要危险因素;两组患者在入院时冠心病各项危险因素控制均较差,两组之间比较差异无统计学意义(P>0.05),出院6个月,对照组组内比较显示血压及饮食控制较入院时好(P<0.05),余5项指标控制均较差(P>0.05),动机组组内比较显示,7项指标控制均较好(P<0.05),出院6个月,动机组各项指标均较对照组好(P<0.05);两组患者在入院时得分及服药依从性均较差,两组之间比较差异无统计学意义(P>0.05),出院6个月,对照组组内显示得分高于入院时(18.6±1.8 vs 16.2±1.1,P<0.05),但服药依从性与入院时比较仍无差异(P>0.05);动机组组内比较显示,得分及服药依从性均高于入院时(25.6±1.4 vs 15.8±0.8,P<0.05;67.5%vs 11.3%,P<0.05);出院6个月,动机组得分及服药依从性均高于对照组(25.6±1.4 vs 18.6±1.8,P<0.05;67.5%vs 22.5%,P<0.05)。结论:MI可提高冠心病支架植入患者对危险因素的控制,提高服药依从性。
Objective:To explore the impact of motivational interviews on risk factor control and medication compliance in patients with coronary heart disease undergoing stent implantation.Methods:160 patients who met the inclusion criteria were selected using a random number table method and randomly divided into a control group and an intervention group,with 80 patients in each group.The mobile unit adopts MI to conduct in and out of hospital follow-up on patients,focusing on the control of coronary heart disease risk factors and medication compliance.Through the interview,problems with the patient's lifestyle and medication habits are identified,and solutions are developed in collaboration with the patient;The control group was given the currently recognized methods to improve the compliance of patients after PCI.At admission and 6 months after discharge,the risk factor control status and medication compliance of the two groups of patients were evaluated using the risk factor questionnaire and medication compliance questionnaire respectively.Results:The results of Logistic regression showed that gender,income,education,diabetes,hyperlipidemia,hypertension,smoking,exercise and BMI index were the main risk factors for poor drug compliance of patients with coronary heart disease.The control of various risk factors for coronary heart disease was poor between the two groups of patients at admission,and there was no statistically significant difference between the two groups(P>0.05),after 6 months of discharge,the control group showed better blood pressure and dietary control compared to admission(P<0.05),while the remaining 5 indicators were poorly controlled(P>0.05),the remaining 5 indicators are poorly controlled(P>0.05),comparison within the rotating unit group showed that all 7 indicators were well controlled(P<0.05).After 6 months of discharge,all indicators of the rotating unit were better than those of the control group(P<0.05);Adherence at admission,and there was no statistically significant difference between the two groups(P>0.05).After 6 months of discharge,the control group showed higher scores than at admission(18.6±1.8 vs 16.2±1.1,P<0.05),but medication adherence remained unchanged compared to at admission(P>0.05);Comparison within the mobile unit group showed that the scores and medication adherence were higher than those at admission(25.6±1.4 vs 15.8±0.8,P<0.05;67.5%vs 11.3%,P<0.05);After 6 months of discharge,the score and medication compliance of the motivation group were higher than those of the control group(25.6±1.4 vs 18.6±1.8,P<0.05;67.5%vs 22.5%,P<0.05).Conclusion:MI can improve the control of risk factors and medication compliance in patients with coronary heart disease undergoing stent implantation.
作者
范栋辉
高艳霞
任化立
FAN Donghui;GAO Yanxia;REN Huali(Department of Emergency,The first Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,CHN;Department of Internal Medicine,Rehabilitation Hospital of Zhengzhou Cigarerre Factory,Zhengzhou 450000,CHN)
出处
《河南大学学报（医学版）》
CAS
2023年第5期381-386,共6页
Journal of Henan University:Medical Science
基金
河南省自然科学基金(202300410396)。
关键词
动机性访谈
冠心病
危险因素
motivational interview
coronary heart disease
risk factors
