异基因造血干细胞移植患者免疫抑制剂服药依从性现状及影响因素分析  

Status and influencing factors of compliance with immunosuppressive drugs in patients with allogeneic hematopoietic stem cell transplantation

作　　者：杨玉佩 杨方英[2] 吕秀燕[1] 沈王芳[3] 章蓓蕾[4] Yang Yupei;Yang Fangying;Lyu Xiuyan;Shen Wangfang;Zhang Beilei(Department of Hematology,Taizhou Hospital of Zhejiang Province,Taizhou 317000,China;Nursing Department,Zhejiang Cancer Hospital,Hangzhou 310022,China;Department of Hematology,Zhejiang Provincial Hospital of Traditional Chinese Medicine,Hangzhou 310003,China;Department of Hematology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]浙江省台州医院血液科,台州317000 [2]浙江省肿瘤医院护理部,杭州310022 [3]浙江省中医院血液科,杭州310003 [4]温州医科大学附属第一医院血液科,温州325015

出　　处：《中华现代护理杂志》2022年第9期1195-1201,共7页Chinese Journal of Modern Nursing

摘　　要：目的了解异基因造血干细胞移植(allo-HSCT)患者免疫抑制剂服药依从性现状,探讨其服药依从性的影响因素。方法本研究为横断面研究。采用便利抽样法,选取2020年3月—2021年2月在浙江省台州医院、浙江省中医院、温州医科大学附属第一医院移植中心随访的238例allo-HSCT患者为研究对象。采用自行设计的一般资料调查表、免疫抑制药物依从性Basel评估量表、中文版服药信念特异性量表、一般自我效能感量表、领悟社会支持量表、家庭关怀度指数量表对患者进行现场调查。采用Pearson相关分析探讨allo-HSCT患者服药依从性与服药信念、自我效能、社会支持、家庭关怀度之间的相关性。采用多重线性回归分析探讨allo-HSCT患者免疫抑制剂服药依从性的影响因素。结果本次调查研究共发放调查问卷238份,最终回收有效问卷为228份。allo-HSCT患者服药依从性得分为(4.80±1.18)分,有111例(48.68%,111/228)患者服药依从性差,其中不按时服药的发生率最高,占44.30%(101/238)。多重线性回归分析结果显示,家庭平均月收入、排斥反应、服药信念、社会支持和家庭关怀度是服药依从性的影响因素(P<0.05)。结论allo-HSCT患者免疫抑制剂服药依从性处于中低水平,移植患者家庭月平均收入、排斥反应、服药信念、社会支持和家庭关怀度是影响免疫抑制剂服药依从性的主要因素,医护人员应根据服药依从性的影响因素制订针对性的干预措施,以改善allo-HSCT患者免疫抑制剂服药依从性。Objective To understand the current status of the compliance of immunosuppressive drugs in patients with allogeneic hematopoietic stem cell transplantation(allo-HSCT)and to explore the influencing factors of their compliance.Methods This study was a cross-sectional study.Using the convenient sampling method,a total of 238 allo-HSCT patients who were followed up in the Transplant Center of Taizhou Hospital of Zhejiang Province,Zhejiang Provincial Hospital of Traditional Chinese Medicine and the First Affiliated Hospital of Wenzhou Medical University from March 2020 to February 2021 were selected as the research objects.The self-designed general information questionnaire,Basel Assessment Scale for Immunosuppressive Drug Compliance,Chinese version of Medication Belief-Specific Scale,General Self-Efficacy Scale,Perceived Social Support Scale and Family Care Index Scale were used for on-site investigation of patients.Pearson correlation analysis was used to analyze the correlation between medication compliance and medication belief,self-efficacy,social support and family care of allo-HSCT patients.Multiple linear regression analysis was used to investigate the influencing factors of immunosuppressive medication compliance in allo-HSCT patients.Results A total of 238 questionnaires were distributed in this study,and 228 valid questionnaires were finally recovered.The medication compliance score of allo-HSCT patients was(4.80±1.18)points.And 111 patients(48.68%,111/228)had poor medication compliance,among which the incidence of not taking medication on time was the highest,accounting for 44.30%(101/238).Multiple linear regression analysis showed that average monthly family income,rejection,medication belief,social support and family care were the influencing factors of medication compliance(P<0.05).Conclusions The immunosuppressant medication compliance of allo-HSCT patients is at a medium and low level.Average monthly family income,rejection reaction,medication belief,social support and family care are the main factor

关 键 词：造血干细胞移植 免疫抑制剂 药物治疗依从性 影响因素 

分 类 号：R457.7[医药卫生—治疗学]