本文選題：炎癥性腸病 + 潰瘍性結(jié)腸炎��； 參考：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]1.調(diào)查云南省炎癥性腸病患者藥物依從性及患者對(duì)疾病知識(shí)掌握現(xiàn)狀;2.明確炎癥性腸病患者藥物依從性及疾病知識(shí)的影響因素。[方法]選取2015年1月1日至2017年1月1日在云南省昆明醫(yī)科大學(xué)第一附屬醫(yī)院消化內(nèi)科診斷明確的145例炎癥性腸病患者,運(yùn)用一般資料問卷、Morisky藥物依從性量表(MMAS-8)、中文版克羅恩病與結(jié)腸炎知識(shí)問卷(CCKNOW)進(jìn)行調(diào)查并收集相關(guān)資料,數(shù)據(jù)用SPSS21.0軟件進(jìn)行統(tǒng)計(jì)分析,經(jīng)t檢驗(yàn)、方差分析、卡方檢驗(yàn)及線性回歸分析分析IBD患者藥物依從性、疾病知識(shí)現(xiàn)況及其相關(guān)影響因素。[結(jié)果]1.138例患者完成問卷調(diào)查,其中男性86例(62.3%),女性52例(37.7%)。平均年齡42.71 ±15.66歲,最小年齡為14歲,最大年齡為80歲,潰瘍性結(jié)腸炎100例(72.5%),克羅恩病患者38例(27.5%)。調(diào)查所示,MMAS總得分為4.47±1.44(1.25～7.75)分,其中UC患者M(jìn)MAS得分為4.38±1.34分,低于CD患者依從性得分4.70±1.66分,但統(tǒng)計(jì)假設(shè)未達(dá)顯著水平(P=0.244),尚不能認(rèn)為UC患者的藥物依從性比CD患者低。119例患者依從性差,占86.2%,其中UC患者89例(89.0%),CD患者30例(78.9%);17例患者依從性中等,占12.3%,其中UC患者10例(10.0%),CD患者7例(18.4%);2例患者依從性好,占1.4%,其中 UC 患者 1 例(1.0%),CD 患者 1 例(2.6%)。2.IBD患者M(jìn)MAS評(píng)分與婚姻狀況(P=0.033)、文化程度(P=0.044)、學(xué)生狀態(tài)(P=0.049)、用藥方案是否清楚(P=0.016)、服用激素(P=0.020)相關(guān)。與性別、年齡、民族、生育狀況、居住狀況、就業(yè)狀態(tài)、年收入、醫(yī)療付費(fèi)方式、吸煙、飲酒無關(guān)。3.138例IBD患者CCKNOW平均總得分為9.23±4.65(0～21)分,其中,UC患者CCKNOW平均總得分為8.81±4.66分,CD患者為10.34±4.50分,但統(tǒng)計(jì)假設(shè)未達(dá)到顯著水平(P=0.084),尚不能認(rèn)為UC患者的疾病知識(shí)掌握低于CD患者。4.IBD患者CCKNOW得分與婚姻狀況(P=0.009)、生育狀況(P=0.014)、文化程度(P=0.000)、就業(yè)狀態(tài)(P=0.020)、用藥方案是否清楚(P=0.003)、服用激素(P=0.023)、醫(yī)療付費(fèi)方式(P=0.025)、胃腸道手術(shù)(P=0.027)相關(guān)。與性別、年齡、民族、居住狀況、年收入、吸煙、飲酒無關(guān)。5.患者M(jìn)MAS評(píng)分與其自身的CCKNOW得分呈正相關(guān)。[結(jié)論]1.云南省炎癥性腸病患者的藥物依從性現(xiàn)狀不容樂觀,患者藥物依從性與婚姻狀況、文化程度、學(xué)生狀態(tài)、用藥方案是否清楚、服用激素密切相關(guān)。消化科醫(yī)生應(yīng)在患者藥物治療過程中關(guān)注和管理患者用藥行為,實(shí)時(shí)評(píng)估并加以干預(yù)。2.云南省炎癥性腸病患者疾病知識(shí)掌握現(xiàn)狀整體不佳,患者的疾病知識(shí)與婚姻狀況、生育狀況、文化程度、就業(yè)狀態(tài)、用藥方案是否清楚、服用激素、醫(yī)療付費(fèi)方式、有無胃腸道手術(shù)史相關(guān)。3.疾病相關(guān)知識(shí)對(duì)患者藥物依從性有較大的影響,提高患者疾病相關(guān)知識(shí)水平,加強(qiáng)患者健康教育及自我管理,可以提高患者藥物依從性從而改善患者的健康相關(guān)生活質(zhì)量。
[Abstract]:[objective] 1. To investigate the drug compliance and knowledge of inflammatory bowel disease patients in Yunnan Province. To determine the drug compliance and disease knowledge of inflammatory bowel disease patients. [methods] 145 patients with inflammatory bowel disease were selected from January 1, 2015 to January 1, 2017 in the Department of Gastroenterology, the first affiliated Hospital of Kunming Medical University of Yunnan Province. The Morisky drug compliance scale (MMAS-8A) and the Chinese version of CCKNOW (knowledge questionnaire on Crohn's Disease and Colitis) were used to investigate and collect relevant data. The data were statistically analyzed by SPSS21.0 software, and analyzed by t-test and ANOVA. Chi-square test and linear regression analysis of drug compliance, disease knowledge and related factors in patients with IBD. [results] A questionnaire survey was completed in 1.138 patients, of whom 86 were male (62.3%) and 52 were female (37. 7%). The average age was 42.71 鹵15.66 years old, the minimum age was 14 years old, the maximum age was 80 years old. There were 100 cases of ulcerative colitis and 72.5%, 38 cases of Crohn's disease. The total score of MMAs was 4.47 鹵1.44 鹵1.257.75). The MMAS score of UC patients was 4.38 鹵1.34, which was lower than that of CD patients (4.70 鹵1.66), but the statistical hypothesis was not significant (P < 0.244). The drug compliance of UC patients was lower than that of CD patients. Among them, 89 patients with UC and 30 patients with CD with 78.9% had moderate compliance, accounting for 12.3%. Among them, 10 patients with UC had 10 cases with 10.0 CD and 7 patients with 18. 4% CD, and 2 patients had good compliance. Among them, 1 case with UC and 1 case with CD were related to marital status (P < 0.033), education level (P < 0.044), student status (P < 0.049), drug regimen (P < 0.016) and steroid (P 0.020). The average total CCKNOW score of IBD patients was 9.23 鹵4.650.21, compared with sex, age, nationality, fertility, living status, employment status, annual income, medical payment, smoking and drinking. The average total CCKNOW score of UC patients was 8.81 鹵4.66 and that of CD patients was 10.34 鹵4.50. However, the statistical hypothesis does not reach the significant level of P0. 084, it can not be considered that the disease knowledge of UC patients is lower than that of CD patients. 4. The CCKNOW score and marital status of patients with IBD are lower than that of patients with CD, the fertility status is 0. 014%, the education level is 0. 000%, the employment status is 0. 020%, whether the medication plan is clear P0. 003 or not. It is related to the use of the hormone P0. 023, the way of paying for medical treatment is 0. 025, and the gastrointestinal operation is P0. 027). It has nothing to do with sex, age, nationality, living condition, annual income, smoking and drinking. There was a positive correlation between MMAS score and CCKNOW score. [conclusion] 1. The current status of drug compliance in patients with inflammatory bowel disease in Yunnan Province is not optimistic. Drug compliance is closely related to marital status, education level, student status, drug use plan and hormone use. The digestive doctor should pay attention to and manage the behavior of the patient in the course of drug treatment, evaluate and intervene. 2. 2. The status quo of disease knowledge in patients with inflammatory bowel disease in Yunnan Province is not good. The patients' disease knowledge and marital status, fertility status, education, employment status, drug use plan, taking hormones, and paying for medical treatment are clear. There is no history of gastrointestinal surgery. Disease related knowledge has great influence on patients' drug compliance. Improving patients' disease related knowledge, strengthening patients' health education and self-management can improve patients' drug compliance and improve patients' health-related quality of life.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R574

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