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就诊于过渡护理门诊可改善炎症性肠病患者对医学的信念和态度。

Transition clinic attendance is associated with improved beliefs and attitudes toward medicine in patients with inflammatory bowel disease.

机构信息

Nancy Fu, Brian Bressler, Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.

出版信息

World J Gastroenterol. 2017 Aug 7;23(29):5405-5411. doi: 10.3748/wjg.v23.i29.5405.

Abstract

AIM

To evaluated the differences in knowledge, adherence, attitudes, and beliefs about medicine in adolescents with inflammatory bowel disease (IBD) attending transition clinics.

METHODS

We prospectively enrolled patients from July 2012 to June 2013. All adolescents who attended a tertiary-centre-based dedicated IBD transition clinic were invited to participate. Adolescent controls were recruited from university-affiliated gastroenterology offices. Participants completed questionnaires about their disease and reported adherence to prescribed therapy. Beliefs in Medicine Questionnaire was used to evaluate patients' attitudes and beliefs. Beliefs of medication overuse, harm, necessity and concerns were rated on a Likert scale. Based on necessity and concern ratings, attitudes were then characterized as accepting, ambivalent, skeptical and indifferent.

RESULTS

One hundred and twelve adolescents were included and 59 attended transition clinics. Self-reported adherence rates were poor, with only 67.4% and 56.8% of patients on any IBD medication were adherent in the transition and control groups, respectively. Adolescents in the transition cohort held significantly stronger beliefs that medications were necessary ( = 0.0035). Approximately 20% of adolescents in both cohorts had accepting attitudes toward their prescribed medicine. However, compared to the control group, adolescents in the transition cohort were less skeptical of (6.8% 20.8%) and more ambivalent (61% 34%) (OR = 0.15; 95%CI: 0.03-0.75; = 0.02) to treatment.

CONCLUSION

Attendance at dedicated transition clinics was associated with differences in attitudes in adolescents with IBD.

摘要

目的

评估在接受炎症性肠病(IBD)过渡门诊的青少年中,对医学知识、治疗依从性、态度和信念的差异。

方法

我们于 2012 年 7 月至 2013 年 6 月前瞻性地招募患者。邀请所有参加三级中心炎症性肠病专门过渡门诊的青少年参加。从大学附属胃肠病学办公室招募青少年对照组。参与者完成了关于他们疾病的问卷,并报告了对规定治疗的依从性。使用医学信念问卷评估患者的态度和信念。对药物过度使用、危害、必要性和担忧的信念进行了李克特量表评分。根据必要性和担忧评分,然后将态度特征化为接受、矛盾、怀疑和漠不关心。

结果

共纳入 112 名青少年,其中 59 名参加了过渡门诊。自我报告的依从率较差,仅有 67.4%和 56.8%的过渡组和对照组患者分别对任何 IBD 药物治疗有依从性。过渡组的青少年对药物治疗的必要性有更强的信念( = 0.0035)。约 20%的过渡组和对照组青少年对其处方药物持接受态度。然而,与对照组相比,过渡组的青少年对治疗的怀疑程度较低(6.8% 20.8%),矛盾程度较高(61% 34%)(OR = 0.15;95%CI:0.03-0.75; = 0.02)。

结论

参加专门的过渡门诊与青少年 IBD 患者的态度差异有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8bc9/5550790/0c4b17a2c5a6/WJG-23-5405-g001.jpg

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