Neurological and Neurosurgical Nursing Department, Faculty of Health Science, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland.
Polish Association of Neuroscience Nursing, Poland.
Int J Med Sci. 2021 Aug 27;18(15):3609-3614. doi: 10.7150/ijms.61964. eCollection 2021.
The aim of the study was to clarify whether the motor disability and the fatigue-related syndrome affect the level of compliance with therapeutic recommendations. Prospective studies were conducted among 165 patients treated under the drug program - Treatment of Multiple Sclerosis (MS) at the Department of Neurology and Clinical Neuroimmunology of the Regional Specialist Hospital in Grudziadz (Poland). The research was carried out by the method of diagnostic survey, questionnaire technique with the use of standardized research tools. The Adherence in Chronic Diseases Scale (ACDS) was used to assess the level of compliance with therapeutic recommendations. The Expanded Disability Status Scale (EDSS) was used to assess the degree of disability, and the Modified Fatigue Impact Scale (MFIS) was used to assess the degree of disability. The Chi-square test, Shapiro-Wilk test and Kruskal-Wallis were used. The statistical analysis showed that there is a relationship (p=0.0055) between the patient's motor disability assessed in the EDSS scale and the level of compliance with therapeutic recommendations assessed in the ACDS scale. The higher the patient's disability level (EDSS 4.5-6.5), the lower the treatment adherence rate. The conducted research shows that the average score in the MFIS scale for individual levels of compliance with therapeutic recommendations expressed in the ACDS scale is, respectively: for the low level - 38.3 MFIS points, for the medium level - 34.4 MFIS points and for the high level- 33.2 MFIS points. The obtained results were not statistically significant (p=0.6098). It was found that the level of adherence to therapeutic recommendations in patients with relapsing-remitting multiple sclerosis treated with immunomodulation in the study group remained high. There is a relationship between the patient's disability and the level of adherence to therapeutic recommendations.
本研究旨在阐明运动障碍和与疲劳相关的综合征是否会影响治疗建议的遵循程度。在波兰格但斯克地区专家医院神经病学和临床神经免疫学系的药物治疗多发性硬化症（MS）计划下，对 165 名患者进行了前瞻性研究。研究采用诊断性调查方法、问卷调查技术和标准化研究工具进行。采用慢性病遵医行为量表（ACDS）评估治疗建议的遵医程度。采用扩展残疾状况量表（EDSS）评估残疾程度，采用改良疲劳影响量表（MFIS）评估疲劳程度。采用卡方检验、Shapiro-Wilk 检验和 Kruskal-Wallis 检验。统计分析显示，患者在 EDSS 量表中评估的运动障碍与在 ACDS 量表中评估的治疗建议遵医程度之间存在相关性（p=0.0055）。患者的残疾程度越高（EDSS 4.5-6.5），治疗依从率越低。研究表明，在 ACDS 量表中，不同遵医程度（低水平、中水平和高水平）在 MFIS 量表中的平均得分分别为：低水平为 38.3 MFIS 点，中水平为 34.4 MFIS 点，高水平为 33.2 MFIS 点。结果无统计学意义（p=0.6098）。发现研究组接受免疫调节治疗的复发性缓解型多发性硬化症患者治疗建议的依从程度仍保持较高水平。患者的残疾程度与治疗建议的依从程度之间存在相关性。
