结直肠癌患者口服化疗药服药依从性及影响因素的纵向调查

摘要

目的 探索结直肠癌患者口服卡培他滨化疗不同时期的服药依从性及影响因素.方法 采用Morisky服药依从性问卷、服药信念特异性问卷、癌症生活质量问卷对119例口服卡培他滨化疗的结直肠癌患者于服药初期(第1周期结束时)、服药中期(第4周期结束时)、服药末期(第8周期结束时)进行调查.结果 共15例患者放弃服药,其中12例在服药前3周期放弃服药.服药初期患者服药依从性得分为7.43±1.00,服药中期为6.98±1.13,服药末期为6.83±1.30,不同时期得分有统计学差异(P＜0.05).回归分析显示,服药初期服药依从性的预测因子为食欲丧失、文化程度、服药信念,服药中期为疲乏、是否造口,服药末期为居住地为上海或其他省市.结论 结直肠癌口服化疗药患者在服药前3个周期最易放弃服药,未放弃服药的患者总体上服药依从性较好,且在不同化疗时期服药依从性受不同因素影响,护理人员应针对性地制定护理措施.%Objective To explore medication compliance and influencing factors at different stages of chemotherapy for orally taking capecitabine patients with colorectal cancer.Methods Totally 119 colorectal cancer patients orally taking capecitabine were investigated using Morisky Medication Adherence Scale 8(MMAS-8),quality of life questionnaire cancer30(EORTC QLQC30) and Beliefs about Medicines Questionnaire Specific(BMQ Specific) at the early stage (at the end of the first cycle),the middle stage (at the end of the 4 cycle) and the terminal stage (at the end of the 8 cycle) of medication.Results A total of 15 patients gave up taking medication,and 12 of them gave up at the first 3 cycles of chemotherapy.The scores of patients' medication compliance at the early stage,the middle stage and the terminal stage was 7.43±1.00,6.98±1.13 and 6.83±1.30 respectively,and there were significant differences among the scores at different stage (P＜0.05).Regression analysis showed that,the predictors of medication compliance were loss of appetite,educational background and beliefs in medication at the early stage,fatigue and stoma at the middle stage,and living in Shanghai or other provinces and cities at the terminal stage.Conclusion Colorectal cancer patients undergoing oral chemotherapy are prone to give up medication in the first 3 cycles,and the patients who didn't give up totally have good medication compliance,which are influenced by different factors at different stage,thus nursing staff should formulate targeted nursing interventions.