基于保护动机理论的儿童抽动障碍患者用药依从性研究
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篇名: 基于保护动机理论的儿童抽动障碍患者用药依从性研究
TITLE:
摘要:
目的研究儿童抽动障碍TD患者用药依从性现状及影响因素为改善儿童TD患者的用药依从性提供依据方法
于保护动机理论设计调查问卷采用横断面调查研究方法于20181-201912月对四川大学华西第二医院确诊的儿童TD 患者进行问卷调查并根据理论假设建立结构方程模型采用极大似然法估计模型对单因素分析中有显著影响的因素进行多元 线性回归分析并开展路径分析和中介效应检验结果共纳入317例患者平均年龄为8.38±2.54平均病程为3.19±2.46用药依从性平均得分为5.70±1.69其中15.1为依从性低37.5为依从性中等47.3为依从性高多元线性回归分析 显示有无共患病β=0.124SE=0.167P=0.011)、主要监护人受教育程度β=0.236SE=0.110P<0.000 1)、生活质量β0.399SE=0.112P<0.000 1和服用药物种类β=0.166SE=0.047P=0.001是影响儿童TD患者用药依从性的影响因素构方程模型分析显示严重性β=0.29595置信区间0.103~0.493)、外部回报β=0.83095置信区间0.662~1.002)、自我效 β=0.20095置信区间0.057~0.353)、易感性β=0.22095置信区间0.084~0.352和生活质量β=0.35395置信区0.211~0.500对患者用药依从性均有直接的正向影响生活质量在外部回报和依从性变量之间起中介作用中介效应占总效 应值的13.9)。结论儿童TD患者用药依从性不高建议各级医疗机构的儿科医务工作者从严重性易感性外部回报和自我效 能去管理患者的用药依从性以提高患者及其监护人对疾病及用药不依从的严重性和易感性的认识同时弱化外部回报和增加自 我效能最终提升患者的用药依从性
ABSTRACT:
OBJECTIVETo study the current status and influencing factors of medication compliance in children with tic disorderTD),and to provide reference for improving medication compliance in TD children. METHODSThe questionnaire was
designed according to the protection motivation theory. The cross-sectional study was adopted to conduct questionnaire survey
among TD children in West China Second Hospital of Sichuan University from Jan. 2018 to Dec. 2019. The structural equation
model was established according to the theoretical assumptionsand the maximum likelihood method was used to estimate the
modelmultiple linear regression analysis was carried out for the factors with significant influence in the single factor analysisand
path analysis and intermediary effect test were carried out. RESULTSA total of 317 patients with TD were includedthe mean age was8.38±2.54yearsand the mean course of disease was3.19±2.46years. Average medication compliance scores was 5.70±1.69),among which 15.1was low compliance37.5moderate complianceand 47.3high compliance. Multivariate linear regression analysis showed that comorbiditiesβ=0.124SE=0.167P=0.011),education level of the main guardianβ0.236SE=0.110P<0.001),quality of lifeβ=0.399SE=0.112P<0.001and the types of drugs takenβ=0.166SE0.047P=0.001were the factors affecting medication compliance of children with TD. Structural equation model analysis showed that severityβ=0.29595CI0.103-0.493),external returnβ=0.83095CI
0.662-1.002),self-efficacyβ=0.20095CI0.057-0.353),susceptibilityβ=0.22095CI0.084-0.352and quality of lifeβ=0.35395CI0.211-0.500had a direct positive impact on medication compliance. Quality of life mediated between external returns and compliance variablesintermediary effect accounted for 13.9of the total effect value. CONCLUSIONSChildren with TD have low medication compliance. It is recommended that pediatricians in medical institutions at all levels to manage the medication compliance of patients with TD from the severitysusceptibilityexternal returns and self-efficacyso as to improve patients and guardiansawareness of the severity and susceptibility of disease and medication non-adherenceweaken external returns and increase self-efficacyand ultimately improve medication compliance of patients
期刊: 2021年第32卷第19期
作者: 杨春松,张伶俐,李佳圆,俞 丹,杨亚亚,吴小芳
AUTHORS: ANG Chunsong,ZHANG Lingli,LI Jiayuan,YU Dan,YANG Yaya,WU Xiaofang
关键字: 儿童;抽动障碍;用药依从性;保护动机理论;结构方程模型;影响因素
KEYWORDS: Children; Tic disorder; Medication compliance; Protective motivation theory; Structural equation model;
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