Wasilewski Grzegorz Jan, Milaniak Irena, Janik Łukasz, Sadowski Jerzy, Przybyłowski Piotr
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, Medical College, John Paul II Hospital, Krakow, Poland.
Kardiochir Torakochirurgia Pol. 2014 Sep;11(3):343-8. doi: 10.5114/kitp.2014.45689. Epub 2014 Sep 28.
Adherence to therapeutic recommendations, concerning in particular drug administration, diet and healthy life style, is essential to obtain optimal medical treatment effects. Elevated blood pressure is an extremely important risk factor for cardiovascular diseases such as coronary artery disease, chronic heart failure and stroke, as well as chronic kidney disease.
The aim of the study was to assess the level of adherence among heart transplant recipients and to explain the reasons for non-adherence phenomenon.
The study was performed on 55 heart allograft recipients: 11 women (20%) and 44 men (80%), all hypertensive. Participation in the study was voluntary and the three-part questionnaire was anonymous to obtain reliable answers. The second part was designed using the Modified Morisky Scale (MMS) consisting of questions assessing motivation and knowledge among patients. The third included questions concerning lifestyle, reasons for non-adherence and methods to improve it.
In self-assessment of the adherence to medical recommendations on a scale of 0 to 10 the analyzed population estimated their level of adherence to be on average 8.49 ± 1.33, which is a considerably high result. It was discovered that both the level of motivation (2.20) and knowledge (2.83) are high among heart transplant recipients. Still, the level of knowledge was significantly higher than the motivation (p < 0.005). Correlation analysis revealed that the self-assessed adherence level correlated positively with the level of motivation (r = 0.357; p < 0.007).
Creation of an active attitude of the patient in the process of treatment is a crucial and at the same time often difficult task demanding cooperation of the patient, the patient's close family and the whole therapeutic team.
遵循治疗建议，尤其是药物服用、饮食和健康生活方式方面的建议，对于获得最佳治疗效果至关重要。高血压是冠心病、慢性心力衰竭和中风等心血管疾病以及慢性肾病的极其重要的危险因素。
本研究的目的是评估心脏移植受者的依从性水平，并解释不依从现象的原因。
对55例心脏移植受者进行了研究，其中11名女性（20%）和44名男性（80%），均患有高血压。参与研究是自愿的，且三份问卷均为匿名，以获得可靠的答案。第二部分采用改良的莫利斯基量表（MMS）设计，该量表由评估患者动机和知识的问题组成。第三部分包括有关生活方式、不依从原因及改善方法的问题。
在0至10分的医疗建议依从性自我评估中，分析人群估计其依从性水平平均为8.49±1.33，这是一个相当高的结果。研究发现，心脏移植受者的动机水平（2.20）和知识水平（2.83）都很高。不过，知识水平显著高于动机水平（p<0.005）。相关性分析显示，自我评估的依从性水平与动机水平呈正相关（r=0.357；p<0.007）。
在治疗过程中培养患者的积极态度是一项关键且往往困难的任务，需要患者、其近亲以及整个治疗团队的合作。
