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参与或完成针灸试验的就诊态度与意愿:一项横断面研究。

Attitude and willingness of attendance for participating in or completing acupuncture trials: a cross-sectional study.

作者信息

Li Xin-Lin, Cao Hui-Juan, Zhang Ya-Jing, Hu Rui-Xue, Lai Bao-Yong, Zhao Nan-Qi, Hu Hui, Xie Zhan-Guo, Liu Jian-Ping

机构信息

Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Chaoyang District, Beijing 100029, China,

The Department of Acupuncture and Metabolic Diseases, Eastern Hospital Affiliated to Beijing University of Chinese Medicine, Fengtai District, Beijing, China.

出版信息

Patient Prefer Adherence. 2018 Dec 24;13:53-61. doi: 10.2147/PPA.S173202. eCollection 2019.

Abstract

OBJECTIVE

To explore the influence of patients' participation in and completing the acupuncture clinical trials through a cross-sectional survey. In addition, we explored potential factors involved in improving patient's compliance to treatment, thus enhancing the quality of acupuncture clinical studies.

METHODS

A survey was conducted at outpatient department of acupuncture and metabolic diseases in two hospitals in Beijing. The semi-structured questionnaire was designed based on literature review and Delphi methods. It contains 15 questions related to patients' experience and attitude. SPSS 22.0 was used for analyses. OR and 95% CI were used for dichotomous outcomes. Logistic regression analysis (LRA) and multi-LRA were used to explore the factors influencing patients' participation or completion and the relationship between demographic characteristics and potential factors.

RESULTS

A survey was conducted from April to September 2016. Five hundred patients were consecutively sampled to fill semi-structured questionnaires regardless of their types of disease. The participants (75.2% were female) were in the age range of 15-85 years and all of them completed the survey. The effect and safety of acupuncture therapy were considered to be the deciding factors by 92% and 96% of the respondents, respectively. Only 40 of the surveyed participants (8.0%) had previously participated in the clinical trials. The LRA showed they paid more attention to treatment regimen (frequency and session of treatment) when deciding whether or not to participate in the trials (OR 1.54, 95% CI 1.02-2.34). Multivariate LRA showed that elder people considered cost (OR 1.36, 95% CI 1.09-1.70) to be an important factor, while the participants having medical insurance (OR 1.45, 95% CI -0.20-0.93) thought informed consent was important. Meanwhile, participants with higher education preferred regular follow-up (OR 1.16, 95% CI 0.02-0.28).

CONCLUSION

After providing adequate information regarding the potential benefits and harms of the acupuncture treatment, completion of the treatment within the specific time regimen was found to be the most important factor affecting patient's compliance. Other factors, such as cost and regular follow-up, should also be given special consideration.

摘要

目的

通过横断面调查探讨患者参与并完成针灸临床试验的影响因素。此外,我们还探讨了提高患者治疗依从性的潜在因素,从而提升针灸临床研究的质量。

方法

在北京两家医院的针灸与代谢疾病门诊进行了一项调查。基于文献综述和德尔菲法设计了半结构化问卷。它包含15个与患者经历和态度相关的问题。使用SPSS 22.0进行分析。对于二分结果,使用比值比(OR)和95%置信区间(CI)。采用逻辑回归分析(LRA)和多因素LRA来探讨影响患者参与或完成的因素以及人口统计学特征与潜在因素之间的关系。

结果

于2016年4月至9月进行了调查。连续抽取500名患者填写半结构化问卷,无论其疾病类型如何。参与者(75.2%为女性)年龄在15 - 85岁之间,且全部完成了调查。分别有92%和96%的受访者认为针灸治疗的效果和安全性是决定因素。在接受调查的参与者中,只有40人(8.0%)曾参与过临床试验。LRA显示,他们在决定是否参与试验时更关注治疗方案(治疗频率和疗程)(OR 1.54,95% CI 1.02 - 2.34)。多因素LRA显示,老年人认为费用(OR 1.36,95% CI 1.09 - 1.70)是一个重要因素,而有医疗保险的参与者(OR 1.45,95% CI -0.20 - 0.93)认为知情同意很重要。同时,受过高等教育的参与者更喜欢定期随访(OR 1.16,95% CI 0.02 - 0.28)。

结论

在提供了关于针灸治疗潜在益处和危害的充分信息后,发现在特定时间方案内完成治疗是影响患者依从性的最重要因素。其他因素,如费用和定期随访,也应给予特别考虑。

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