“5个时刻法”在慢性乙型肝炎抗病毒治疗管理中的应用  

Effects of"5-moment method"in antivirus therapy management of chronic hepatitis B

作　　者：王婷婷[1] 赵晓燕[1] 金拼拼[1] 廖小娟[1] 薛黎明[1] Wang Tingting;Zhao Xiaoyan;Jin Pinpin;Liao Xiaojuan;Xue Liming(Department of Infectious Disease,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China)

机构地区：[1]温州医科大学附属第一医院感染内科,温州325000

出　　处：《中华现代护理杂志》2020年第18期2489-2493,共5页Chinese Journal of Modern Nursing

基　　金：温州市基础性科研项目(Y20190298)。

摘　　要：目的探讨“5个时刻法”对慢性乙型肝炎患者抗病毒用药依从性及复诊率的影响。方法采用便利抽样法,选取2019年1—6月在温州医科大学附属第一医院进行抗病毒治疗的慢性乙型肝炎患者120例为研究对象,根据患者入住病区分为对照组和观察组,各60例。对照组行传统干预法,包括常规住院用药宣教、微信推送乙肝相关信息和出院电话随访;观察组实施“5个时刻”干预法,给予患者“5个时刻”用药宣教,引导患者运用“5个时刻”用药知识,主动参与安全抗病毒的自我管理;应用信息化延续服务,将用药“5个时刻法”管理延续到家庭用药管理。采用自行设计的CHB抗病毒药物知识知晓问卷、Morisky药物依从性量表(MMAS-8)比较两组患者用药知识知晓率和用药依从性,比较两组复诊率。研究过程中对照组失访4例,观察组无失访,实际纳入研究对象116例。结果干预6个月后,观察组患者的抗病毒药物知识知晓率(76.79±6.57)%,MMAS-8得分(7.17±0.78)分,均高于对照组,差异有统计学意义(t值分别为19.883、4.382;P<0.01);观察组患者出院后6个月的复诊率为88.33%(53/60),对照组为55.36%(31/56),差异有统计学意义(χ2=15.768,P<0.01)。结论“5个时刻法”可有效提高CHB患者对抗病毒治疗的认知,提高患者抗病毒用药的依从性,提高复诊的配合度,值得在抗病毒治疗管理中推广。Objective To explore the effects of"5-moment method"on antivirus medication compliance and revisit rate among patients with chronic hepatitis B.Methods From January 2019 to June 2019,this study selected 120 chronic hepatitis B patients with antivirus therapy in the First Affiliated Hospital of Wenzhou Medical University as subjects by convenience sampling.All patients were divided into control group and observation group according to wards,60 cases in each group.Control group carried out the traditional intervention including the routine medication education,hepatitis B information push by WeChat and discharged telephone follow-up.Observation group implemented the"5-moment"intervention involving the"5-moment"medication education,guiding patients to actively participate the safe and antiviral self-management through"5-moment"medication knowledge,applying"5-moment method"medication management in family medication management by informationization continuing service.This study compared the medication knowledge and compliance of patients with the self-designed Chronic Hepatitis B Antivirus Medication Knowledge Questionnaire and Morisky Medication Adherence Scale-8(MMAS-8)as well as the revisit rate between two groups.There were 4 cases loss to follow-up in control group and no case loss to follow-up in observation group.A total of 116 subjects were included.Results The awareness rate of antivirus medication knowledge and score of MMAS-8 of patients in observation group 6 months after intervention were(76.79±6.57)%and(7.17±0.78)respectively higher than those in control group with statistical differences(t=19.883,4.382;P<0.01).The revisit rates of observation group and control group 6 months after intervention were 88.33%(53/60)and 55.36%(31/56)respectively with a statistical difference(χ2=15.768,P<0.01).Conclusions The"5-moment method"can effectively improve the cognition of chronic hepatitis B patients on antivirus therapy,antivirus medication compliance of patients and revisit rate which is worthy of popularizatio

关 键 词：肝炎 乙型 5个时刻法 依从性 复诊率 

分 类 号：R512.62[医药卫生—内科学] R193[医药卫生—临床医学]