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骨科大手术后门诊抗凝治疗的依从性现状及影响因素。

Compliance status and influencing factors of anticoagulation therapy in outpatient undergoing major orthopedic surgery.

机构信息

School of Nursing, China Medical University, Liaoning, 110122, China.

Department of Surgical Clinic, The First Affiliated Hospital of China Medical University, Liaoning, 110001, China.

出版信息

Arch Orthop Trauma Surg. 2024 Feb;144(2):583-589. doi: 10.1007/s00402-023-05106-3. Epub 2023 Oct 29.

DOI:10.1007/s00402-023-05106-3
PMID:37898976
Abstract

PURPOSE

This study was designed to investigate influencing factors of out-of-hospital anticoagulation therapy compliance among patients undergoing major orthopaedic surgeries.

METHODS

A cross-sectional, descriptive study was conducted from July 2022 to February 2023 among outpatients who underwent major orthopedic surgery in our hospital. Patients (n = 200) were surveyed using the General Information Questionnaire, the General Self-Efficacy Scale, the Specificity of Medication-Taking Beliefs Scale, and the Morisky Medication Adherence Scale. Factors that influenced patient compliance were also determined using univariate and multivariate regression analyses.

RESULTS

One hundred eighty-three valid questionnaires were returned, the compliance with outpatient anticoagulation therapy among patients undergoing major orthopaedic surgeries was good in 56.3% (103/183) of all cases and poor in 43.7% (80/183). Multivariate logistic regression analysis showed that medication duration, adverse effects, self-efficacy and medication beliefs influenced adherence to out-of-hospital anticoagulation therapy in patients undergoing major orthopedic surgery (P < 0.05).

CONCLUSIONS

Poor compliance with out-of-hospital anticoagulation therapy in patients undergoing major orthopedic surgery is mainly associated with a long course of medication, adverse reactions, low self-efficacy and low medication beliefs. Healthcare staff should strengthen post-discharge anticoagulation management based on relevant influencing factors to enhance patient compliance.

摘要

目的

本研究旨在调查接受大型骨科手术患者院外抗凝治疗依从性的影响因素。

方法

2022 年 7 月至 2023 年 2 月,采用横断面描述性研究方法,对我院门诊接受大型骨科手术的患者进行调查。采用一般资料问卷、一般自我效能感量表、服药信念特异性量表和 Morisky 服药依从量表对患者进行调查。采用单因素和多因素回归分析确定影响患者依从性的因素。

结果

共回收有效问卷 183 份,接受大型骨科手术的患者院外抗凝治疗依从性良好者占 56.3%(103/183),依从性差者占 43.7%(80/183)。多因素 logistic 回归分析显示,用药时间、不良反应、自我效能和用药信念影响接受大型骨科手术患者的院外抗凝治疗依从性(P<0.05)。

结论

接受大型骨科手术的患者院外抗凝治疗依从性差主要与用药时间长、不良反应、自我效能低和用药信念低有关。医护人员应根据相关影响因素加强出院后抗凝管理,提高患者的依从性。

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Antithrombotic Therapy for Venous Thromboembolism.
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