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冠状动脉血管成形术患者的用药依从性及其相关因素

Medication Adherence and its Related Factors in Patients Undergoing Coronary Artery Angioplasty.

作者信息

Salari Arsalan, Rouhi Balasi Leila, Ashouri Asieh, Moaddab Fatemeh, Zaersabet Fatemeh, Nourisaeed Azam

机构信息

Department of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Department of Nursing, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

J Caring Sci. 2018 Dec 1;7(4):213-218. doi: 10.15171/jcs.2018.032. eCollection 2018 Dec.

Abstract

Percutaneous Coronary Intervention (PCI) has no effect on coronary artery atherosclerosis, thus the modification of physiological risk factors seems essential to prevent coronary artery disease (CAD). Then PCI patients have to receive multiple drug therapies in an attempt to prevent the recurrence of cardiac events. In spite of the evidence based on medication adherence to prevent post-PCI CAD development, medication adherence is the main concern for health care system. Accordingly, this study aims to determine the medication adherence and its related factors among these patients. In this cross-sectional study, the statistical community was the patients undergoing PCI at medical educational hospital of Dr. Heshmat in Rasht, Iran. 269 patients were selected by convenient sampling method. The data were collected by a questionnaire consisting of 4 parts, namely the socio-individual factors, Morisky medication adherence scale, hospital anxiety and depression scale and cardiac patient's self-efficacy scale. Data analysis was done by descriptive statistics and the significance variables in univariate analysis were examined in a multi logistic regression model through considering co-linearity. The results showed that 75 patients (28%) didn't adhere to the medication. In addition, the majority of them were reported to have clinical anxiety (44.2%) and mild depression (55.8%). Also, based on the results derived from multiple logistic regressions, only the spouse's educational level and family history of coronary artery disease were significant predictors of medication adherence. The current study findings display lack of complete post-PCI medication adherence, which underscores the importance of the existence of cardiac rehabilitation systems in the society. Therefore, it is recommended that cardiac rehabilitation centers be built in the society.

摘要

经皮冠状动脉介入治疗(PCI)对冠状动脉粥样硬化没有影响,因此改变生理风险因素似乎对预防冠状动脉疾病(CAD)至关重要。于是,PCI患者必须接受多种药物治疗,以预防心脏事件的复发。尽管有基于药物依从性预防PCI后CAD发展的证据,但药物依从性仍是医疗保健系统的主要关注点。因此,本研究旨在确定这些患者的药物依从性及其相关因素。在这项横断面研究中,统计群体是伊朗拉什特赫什马特医生医学教育医院接受PCI的患者。采用方便抽样法选取269例患者。数据通过一份由4部分组成的问卷收集,即社会个体因素、莫里isky药物依从性量表、医院焦虑抑郁量表和心脏病患者自我效能量表。数据分析采用描述性统计方法,单因素分析中的显著变量通过考虑共线性在多元逻辑回归模型中进行检验。结果显示,75例患者(28%)未坚持服药。此外,据报告他们中的大多数人有临床焦虑(44.2%)和轻度抑郁(55.8%)。同样,根据多元逻辑回归得出的结果,只有配偶的教育水平和冠状动脉疾病家族史是药物依从性的显著预测因素。当前的研究结果显示PCI后药物依从性不完整,这凸显了社会中心脏康复系统存在的重要性。因此,建议在社会中建立心脏康复中心。

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