以MI为主的沟通模式对慢性乙肝患者抗HBV-DC诱导治疗依从性的影响

摘要

Objective:To explore the effect of motivational interviewing ( MI) based communication mode on the treatment compliance of chronic hepatitis B ( CHB) patients with anti-HBV-DC.Methods:A total of 120 CHB patients treated with anti-HBV-DC induced therapy were randomly divided into the study group and the control group with 60 cases in each group .During the treatment period , the control group was given routine health education ,and the study group was given effective communication mode ( motivational interview ) on this basis of the control group.The serum levels of hepatitis B surface antigen (HBsAg),hepatitis B virus deoxyribonucleotide (HBV DNA)and ala-nine aminotransferase(ALT)were measured at 0,4,8,12 and 24 weeks of treatment,and the treatment compliance scale,the health status questionnaire(SF-36),the Self-rating Anxiety scale(SAS),the exercise of self-care agency scale(ESCA)score and the adverse reactions were recorded before and after intervention .Results:After the treatment,at 4 weeks,8 weeks,12 weeks and 24 weeks,the serum levels of HBsAg,HBV DNA and ALT in the two groups were significantly lower than those before the intervention and the decreasing degree of the indexes in the study group was significantly greater than those in the control group (P<0.05).The treatment compliance of the study group was significantly higher than that of the control group at 4 weeks,8 weeks,12 weeks and 24 weeks after the treatment(P<0.05).After the intervention ,the SF-36 score and the ESCA score of the study group were significantly higher than those in the control group while the SAS score of the study group was significantly lower than that in the control group (P<0.05).The incidence rate of adverse reactions in the study group was significantly lower than that in the control group during 24 weeks of treatment(P<0.05).Conclusion:MI based communi-cation mode can significantly improve CHB patients′resistance to HBV-DC induced treatment compliance ,while ensuring the efficacy of antiviral therapy,while improving the quality of life,bad mood and self-care ability,thereby reducing adverse drug reactions .%目的:探讨以动机性访谈(MI)为主的沟通模式对慢性乙肝(CHB)患者抗乙肝树突状细胞(HBV-DC)诱导治疗依从性的影响.方法:将120例行抗HBV-DC诱导治疗的CHB患者随机分为研究组和对照组各60例,对照组给予常规健康教育,研究组在此基础上给予MI为主的沟通模式,于治疗开始0、4、8、12和24周分别检测患者血清乙肝表面抗原(HBsAg)、乙肝病毒脱氧核糖核酸(HBV DNA)、丙氨酸转氨酶(ALT)水平,并采用治疗依从性量表、健康状况调查问卷(SF-36)、焦虑自评量表(SAS)、自我护理能力测定量表(ESCA),评估两组治疗依从性、SF-36、SAS、ESCA评分及不良反应.结果:治疗后4、8、12、24周两组血清HBsAg、HBV DNA、ALT均较同组干预前明显下降,且研究组上述指标优于对照组(P<0.05);治疗4、8、12、24周,研究组治疗依从性高于对照组(P<0.05);研究组干预后SF-36、ESCA评分均高于对照组,且SAS评分及不良反应明显低于对照组(P<0.05).结论:以MI为主的沟通模式,可明显提高CHB患者抗HBV-DC诱导治疗依从性,在保证抗病毒疗效同时,改善患者生活质量、不良情绪及自我护理能力,从而减少药物不良反应.