住院期间自我效能干预对肝移植受者依从性的影响

摘要

目的：探讨住院期间有针对性的自我效能干预措施对肝移植受者自我效能及依从性的影响。方法选择2012年10月1日—2014年9月30日在解放军第三0二医院肝移植中心接受肝移植手术的患者64例，根据手术先后顺序进行编号后将患者分为干预组和对照组，对照组在术后实施常规护理和健康宣教，干预组对患者进行有针对性的促进自我效能增强的措施，使用移植注册系统收集患者的一般资料，以问卷的形式收集术前自我效能水平、术后1个月和术后6个月的自我效能以及依从性水平；比较两组患者干预前后的自我效能和依从性。结果两组患者第1，6个月的自我效能感得分比较，差异有统计学意义（P ＜0．01）；干预前后两组患者自我效能得分比较使用重复测量方差分析，结果显示，干预组和对照组之间差异有统计学意义（P ＜0．05），同时，随着时间的变化，两组间差异有统计学意义（P ＜0．05）；干预组在术后第1，6个月在依从性总分、自我监测护理和生活习惯得分均高于对照组，两组比较差异有统计学意义（P ＜0．01），而服药依从性、随访2个分量表得分两组比较差异无统计学意义（P ＞0．05）；两组患者并发症发生差异无统计学意义（P ＞0．05）。结论通过自我效能干预措施可以增强肝移植患者术后的自我效能感，提高患者自我护理的能力，促进健康行为的改善，提高患者术后依从性，提高患者的术后生活质量。%Objective To explore the influences of self-efficacy intervention on compliance and self efficacy of liver transplantation recipients during hospitalization.Methods A total of 64 liver transplantation recipients in liver transplantation center of 302 Military Hospital of China from October 1 st 201 2 to September 30th 201 4 were recruited and divided into intervention group (targeted measures to enhance self efficacy)and control group (routine nursing and health education)according to the serial number designed by sequence of operation.General information of patients was collected by transplantation registration system.Besides,self-efficacy level before operation,self-efficacy and compliance level at 1 ,6 months after operation was evaluated by questionnaire.And then,self-efficacy and compliance were compared between two groups.Results There were statistically significant differences in the score of self efficacy of patients between two groups at 1 st and 6th month (P <0.01 ).The scores of self-efficacy of patients in two groups before and after intervention were analyzed with repeated measurement analysis of variance.The results showed that it was an obvious difference between two groups.At the same time,there was a statistical difference between two groups with the time changing (P <0.05).The scores of compliance,self-monitoring nursing and life habits of patients in intervention group at 1 st and 6th month were higher than those in control group with significant differences (P <0.01 );however,there was no significant difference in medication compliance and scores of two sub-scales (P >0.05).Besides,there was no significant difference on whether complications occurred (P >0.05 ).Conclusions Self-efficacy intervention can enhance self-efficacy of liver transplantation recipients after operation,improve patients′ability of self-care,promote their health behavior and improve patients′compliance so as to improve the quality of life of patients after operation.