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中国 CML 患者及其家属对 TKI 治疗的知识、态度和实践评估。

Assessment of knowledge, attitudes, and practices of CML patients and their families toward TKI therapy in China.

机构信息

Department of Hematology, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, China.

Department of Hematology, People's Hospital of Rizhao, Rizhao, China.

出版信息

Medicine (Baltimore). 2023 Dec 15;102(50):e36498. doi: 10.1097/MD.0000000000036498.

Abstract

The introduction of tyrosine kinase inhibitors (TKIs) has revolutionized chronic myeloid leukemia (CML) treatment. The knowledge, attitude, and practice (KAP) of patients and their families play a significant role in treatment adherence and effectiveness. This study aimed to investigate the KAP of CML patients and their families regarding TKI therapy in China. From November 1 to December 31, 2022, a cross-sectional study was conducted at the Affiliated Huai'an No. 1 People's Hospital in China. A total of 313 CML patients and 268 family caregivers were selected using convenience sampling. Participants answered a self-designed questionnaire. The questionnaire contained demographic/clinical data and assessed KAP toward CML and TKI therapy. Participants exhibited mean KAP scores of 8.91 (55.7%), 33.10 (73.6%), and 2.20 (73.3%), respectively. Family members had higher knowledge and practice scores than patients (both P < .05), with factors such as younger age, urban residency, higher education, employment, higher income, and interaction with peers correlating with better knowledge scores (P < .001). Although participants were well-informed about their diagnosis and medication (>80%), understanding of disease causes (<30%) and treatment prognosis and side effects (<50%) was limited, and cost concerns affected 80.55%. Anxiety and depression were reported more among caregivers (46.64% and 13.8%) than patients (29.71% and 11.51%). While 84.85% adhered to the doctor's instructions, only 68.50% actively sought more CML information. Positive correlations were observed among KAP scores, indicating their interdependence (knowledge-attitude: R = 0.397; knowledge-practice: R = 0.598; attitude-practice: R = 0.353; all P < .001). The findings underscore the importance of tailored education to fill knowledge gaps about CML and the need to address financial concerns and provide psychological support. The positive correlations among knowledge, attitudes, and practices emphasize the need for comprehensive interventions. In conclusion, this study highlights the importance of tailored education, addresses financial concerns, and provides emotional support for CML patients and caregivers in China, despite limitations such as convenience sampling and questionnaire design. Future research should evaluate the effectiveness of educational interventions and long-term outcomes to further enhance the overall well-being of this population.

摘要

酪氨酸激酶抑制剂 (TKI) 的引入彻底改变了慢性髓性白血病 (CML) 的治疗方式。患者及其家属的知识、态度和实践 (KAP) 在治疗依从性和疗效方面起着重要作用。本研究旨在调查中国 CML 患者及其家属对 TKI 治疗的 KAP。2022 年 11 月 1 日至 12 月 31 日,在中国进行了一项横断面研究,在江苏省淮安市第一人民医院进行。采用便利抽样法选取 313 例 CML 患者和 268 名家属进行调查。参与者回答了一份自我设计的问卷。问卷包括人口统计学/临床数据,并评估了参与者对 CML 和 TKI 治疗的 KAP。参与者的 KAP 平均得分分别为 8.91(55.7%)、33.10(73.6%)和 2.20(73.3%)。与患者相比,家庭成员的知识和实践得分更高(均 P<0.05),年轻、城市居住、较高的教育程度、就业、较高的收入和与同龄人互动等因素与更好的知识得分相关(P<0.001)。尽管参与者对诊断和药物治疗了解较好(>80%),但对疾病原因(<30%)和治疗预后及副作用(<50%)的理解有限,费用问题影响了 80.55%的参与者。焦虑和抑郁在照顾者中更为常见(46.64%和 13.8%),而在患者中则较少见(29.71%和 11.51%)。虽然 84.85%的患者遵医嘱治疗,但只有 68.50%的患者积极寻求更多的 CML 信息。KAP 评分之间呈正相关,表明它们相互依赖(知识-态度:R=0.397;知识-实践:R=0.598;态度-实践:R=0.353;均 P<0.001)。研究结果强调了为填补 CML 知识空白进行有针对性教育的重要性,以及解决财务问题和提供心理支持的必要性。知识、态度和实践之间的正相关强调了综合干预的必要性。综上所述,本研究强调了为中国的 CML 患者及其家属提供有针对性教育、解决财务问题和提供情感支持的重要性,尽管存在便利性抽样和问卷设计等局限性。未来的研究应评估教育干预措施的有效性和长期结果,以进一步提高这一人群的整体幸福感。

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