心理干预联合健康宣教对慢性乙型肝炎患者用药依从性及生活质量的影响

Effect of Psychological Intervention Combined with Health Education on Drug Compliance and Quality of Life of Patients with Chronic Hepatitis B

摘要: 目的：探讨心理干预联合健康宣教对慢性乙型肝炎患者用药依从性和生活质量的影响。方法：选择本院2015年6月~2018年7月收治的慢性乙型肝炎患者140例为研究样本，以简单随机法分为常规组和干预组各70例，常规组采取常规保肝、抗病毒干预，干预组在此基础上增加心理干预联合健康宣教。对比两组患者用药依从性、生活质量、健康知识掌握评分、不良事件发生率、肝功能指标。结果：干预组MMAS-8评分(7.61 ± 0.23)分、各项行为依从率(遵医嘱服药92.86%、定期复查95.71%、坚持健康生活方式92.86%)、SF-36评分(134.96 ± 8.04)分、健康知识掌握评分(90.85 ± 6.15)分均高于常规组[MMAS-8评分(7.61 ± 0.23)分、各项行为依从率(遵医嘱服药47.14%、定期复查70.00%、坚持健康生活方式78.57%)、SF-36评分(115.43 ± 6.27)分、健康知识掌握评分(77.30 ± 8.60)分]，且不良事件发生率14.28%均低于常规组不良事件发生率45.71%，P < 0.05。干预前，干预组ALT (202.25 ± 58.59) U/L、AST (162.21 ± 40.37) U/L、TBIL (206.51 ± 52.84) μmol/L、DBIL水平(88.54 ± 21.56) μmol/L和常规组[ALT (199.55 ± 53.42) U/L、AST (158.26 ± 38.14) U/L、TBIL (204.85 ± 50.54) μmol/L、DBIL水平(90.20 ± 33.58) μmol/L]对比无明显差异，P > 0.05；干预后，干预组ALT (31.29±4.01) U/L、AST (30.81 ± 6.09) U/L、TBIL (15.39 ± 2.41) μmol/L、DBIL水平(5.24 ± 1.96) μmol/L低于常规组[ALT (53.24 ± 5.11) U/L、AST (56.79 ± 6.21) U/L、TBIL (23.75 ± 2.25) μmol/L、DBIL水平(10.61 ± 2.33) μmol/L，P < 0.05。结论：心理干预联合健康宣教能提高患者健康知识掌握程度和用药依从性，改善生活质量，值得临床应用。

Abstract: Objective: To explore the effect of psychological intervention combined with health education on drug compliance and quality of life of patients with chronic hepatitis B. Methods: 140 patients with chronic hepatitis B admitted to our hospital from June 2015 to July 2018 were selected as research samples. They were randomly divided into the routine group and the intervention group with 70 cases in each group. The routine group received routine hepatoprotective and antiviral interven-tions. On this basis, the intervention group added psychological intervention and health education. Drug compliance, quality of life, health knowledge mastery score, incidence of adverse events, liver function indicators of patients of the two groups were compared. Results: The scores of MMAS-8 (7.61 ± 0.23), compliance rate of various behaviors (92.86% in compliance with doctor’s orders, 95.71% in regular review, 92.86% in adherence to healthy lifestyle), SF-36 score and health know-ledge mastery score were (7.61 ± 0.23) points, (92.86%, 95.71%, 92.86%), (134.96 ± 8.04) points and (90.85 ± 6.15) points in the intervention group, which were higher than those in the routine group with (7.61 ± 0.23) points, (47.14%, 70.00%, 78.57%), (115.43 ± 6.27) points and (77.30 ± 8.60) points. The incidence of adverse events is 14.28% in the intervention group which was lower than that in the conventional group (45.71%, P < 0.05). Before the intervention, the levels of ALT (199.55 ± 53.42) U/L, AST (204.85 ± 50.54) mol/L, TBIL (206.51 ± 52.84) mol/L, DBIL (88.54 ± 21.56) mol/L, TBIL (204.85 ± 50.54) mol/L, and DBIL (90.20 ± 33.58) mol/L were not significantly different between the intervention group and the control group [ALT (199.55 ± 53.42) U/L, AST (158.26 ± 38.14) U/L, TBIL (204.85 ± 50.54) mol/L], P > 0.05. After intervention, the levels of ALT, AST, TBIL and DBIL in the intervention group were lower than those in the routine group [(31.29 ± 4.01) U/L, (30.81 ± 6.09) U/L, (15.39 ± 2.41) μmol/L and (5.24 ± 1.96) μmol/L vs (53.24 ± 5.11) U/L, (56.79 ± 6.21) U/L, (23.75 ± 2.25) μmol/L and (10.61 ± 2.33) μmol/L] (P < 0.05). Conclusion: Psy-chological intervention combined with health education can improve patients’ health knowledge and medication compliance, and improve the quality of life, worthy of clinical application.