基于健康信念模式的慢性HBV感染者随访依从性影响因素研究  

Influencing factors of adherence to follow⁃up among patients with chronic HBV infection based on health belief model

作　　者：潘登 谢今朝 顾菁[1,2,3] 郝元涛[1,2,3,4] PAN Deng;XIE Jinzhao;GU Jing;HAO Yuantao(Department of Medical Statistics,School of Public Health,Sun Yat-Sen University,Guangzhou 510080,China;Center of Global Health Research,Sun Yat-Sen University,Guangzhou 510080,China;Center for Health Information Research,Sun Yat-Sen Uni-versity,Guangzhou 510080,China;Peking University Center for Public Health and Epidemic Preparedness and Response,Beijing 100191,China)

机构地区：[1]中山大学公共卫生学院医学统计学系,广州510080 [2]中山大学全球卫生研究中心,广州510080 [3]中山大学卫生信息研究中心,广州510080 [4]北京大学公众健康与重大疫情防控战略研究中心,北京100191

出　　处：《中华疾病控制杂志》2023年第5期569-573,615,共6页Chinese Journal of Disease Control & Prevention

基　　金：“十三五”国家科技重大专项(2018ZX10715004)。

摘　　要：目的基于健康信念模式(health belief model,HBM)初步探索慢性HBV感染者随访依从性的影响因素,为慢性HBV感染者的科学管理提供依据。方法于“十三五”期间对广东省重大传染病示范区的慢性HBV感染者开展问卷调查和现场体检。收集感染者的基本特征、HBM相关变量和随访依从情况。采用logistic回归分析模型分析感染者随访依从性的影响因素。结果33.8%的慢性HBV感染者随访依从性差。多因素逐步logistic回归分析模型分析结果提示,HBM相关变量中,障碍认知(OR=1.494,P<0.001)是依从性差的危险因素,易感性认知(OR=0.796,P<0.001)、行为线索(OR=0.701,P<0.001)和自我效能(OR=0.674,P<0.001)是依从性差的保护因素。将研究对象按照HBV DNA分层,同样发现障碍认知是依从性差的危险因素,行为线索和自我效能是依从性差的保护因素。结论易感性认知、障碍认知、行为线索、自我效能均是慢性HBV感染者随访依从性的影响因素,未来可重点通过降低障碍认知和提高自我效能设计干预措施提高感染者随访依从性。Objective To explore the factors influencing the adherence to follow⁃up among pa⁃tients with chronic HBV infection using the health belief model(HBM)and provide a basis for the effec⁃tive management of patients with chronic HBV infection.Methods A questionnaire survey and on⁃site medical examination were conducted among patients with chronic HBV infection in the demonstration areas of major infectious diseases in Guangdong Province during the 13th Five⁃Year Plan period.Data on basic characteristics,HBM⁃related variables,and adherence to follow⁃up were collected.Logistic regression was used to analyze the factors influencing adherence to follow⁃up among patients with chronic HBV infection.Results 33.8%of patients with chronic HBV infection had poor adherence to follow⁃up.The results of multivariate logistic regression(stepwise)suggested that among the HBM⁃related variables,perceived barriers(OR=1.494,P<0.001)was a risk factor for poor adherence,while perceived susceptibility(OR=0.796,P<0.001),cues to action(OR=0.701,P<0.001)and self⁃efficacy(OR=0.674,P<0.001)were protective factors for poor adherence.Stratification of participants by HBV DNA also re⁃vealed that perceived barriers was a risk factor for poor adherence,while cues to action and self⁃efficacy were protective factors for poor adherence.Conclusions Perceived susceptibility,perceived barriers,cues to action,and self⁃efficacy all influence adherence to follow⁃up among patients with chronic HBV in⁃fection.Future interventions can be designed to improve adherence to follow⁃up by focusing on reducing perceived barriers and improving self⁃efficacy.

关 键 词：健康信念模式 乙型肝炎 慢性 随访 影响因素 

分 类 号：R512.62[医药卫生—内科学]