冻融胚胎复苏移植周期患者用药依从性现状及影响因素  

Current status and influencing factors of medication adherence in patients with frozen-thawed embryo transfer

作　　者：童琛晔 倪颖[2] 周文洁 黄立敏[2] 钱闻 TONG Chen-ye;NI Ying;ZHOU Wen-jie;HUANG Li-min;QIAN Wen(Nursing Department in Ruijin Hospital of Shanghai Jiao Tong University,Shanghai 200025;Reproductive Medicine Centre in Ruijin Hospital of Shanghai Jiao Tong University,Shanghai 200025)

机构地区：[1]上海交通大学医学院附属瑞金医院护理部,上海200025 [2]上海交通大学医学院附属瑞金医院生殖医学中心,上海200025

出　　处：《生殖医学杂志》2023年第4期493-503,共11页Journal of Reproductive Medicine

基　　金：上海交通大学医学院附属瑞金医院护理科研基金项目(RJHK-2020-21)。

摘　　要：目的分析体外受精(IVF)患者冻融胚胎移植周期(FET)合理用药依从性现状及影响因素。方法选择2021年1—4月在上海交通大学医学院附属瑞金医院生殖中心行FET助孕的不孕女性患者450例为研究对象。使用一般资料调查、合理用药自我效能量表(SEAMS)、中文版Health希望水平量表(HHI)、社会支持量表(SSRS)调查患者FET周期合理用药依从性现状,筛选临床认为与用药依从性有关及单因素分析有显著差异的变量行多因素Logistic回归分析,分析其影响因素。结果FET助孕患者SEAMS平均得分(30.37±6.62)分,66.07%的患者用药依从性不高,其中不确定因素维度得分率最低。Logistic多元回归分析发现,非首次移植[OR=1.95,95%CI(1.26,3.03),P=0.003]、用药持续时间较长[OR=2.83,95%CI(1.35,5.92),P=0.000]、Health希望水平低[OR=1.28,95%CI(1.21,1.36),P=0.000]和社会支持水平低[OR=1.18,95%CI(1.13,1.23),P=0.000]是FET患者用药依从性低的危险因素。结论FET患者用药依从性并不高,关注非首次移植患者、缩短患者的用药持续时间、提高其希望水平和社会支持水平,可以提高用药依从性。Objective:To analyze the current status and influencing factors of appropriate medication adherence during frozen-thawed embryo transfer(FET)in infertile patients undergoing IVF.Methods:A total of 450 female patients who received FET were selected in Ruijin Hospital of Shanghai Jiao Tong University from January 2021 to April 2021.The general information questionnaire,self-efficacy for appropriate medication use scale(SEAMS),Chinese version of Health Hope Index(HHI),and social support rating scale(SSRS)were used for investigate the patients’status of appropriate medication adherence during the FET cycle.The variables clinically considered to be related to medication adherence and significantly different from univariate analysis were screened for multivariate logistic regression analysis to find the influencing factors of medication adherence during FET.Results:The average SEAMS score of FET patients was(30.37±6.62),and 66.07%of patients did not have high medication adherence.The score rate of uncertainty dimension is the lowest.The results of multiple Logistic regression analysis showed that non-first-time embryo transfer[OR=1.95,95%CI(1.26,3.03),P=0.003],longer duration of FET treatment[OR=2.83,95%CI(1.35,5.92),P=0.000],low score of HHI[OR=1.28,95%CI(1.21,1.36),P=0.000],and low score of SSRS[OR=1.18,95%CI(1.13,1.23),P=0.000]were the risk factors of low medication adherence in FET cycle.Conclusions:The medication adherence of patients with FET is not high.Focusing on the patients with non-first-time embryo transfer cycle,shortening the duration of medication,increasing their score of HHI and SSRS could improve medication adherence.

关 键 词：体外受精-胚胎移植 冻融胚胎移植周期 用药依从性 合理用药自我效能 影响因素 

分 类 号：R711.6[医药卫生—妇产科学]