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目的:探讨以动机性访谈(MI)为主的沟通模式对慢性乙肝(CHB)患者抗乙肝树突状细胞(HBV-DC)诱导治疗依从性的影响。方法:将120例行抗HBV-DC诱导治疗的CHB患者随机分为研究组和对照组各60例,对照组给予常规健康教育,研究组在此基础上给予MI为主的沟通模式,于治疗开始0、4、8、12和24周分别检测患者血清乙肝表面抗原(HBs Ag)、乙肝病毒脱氧核糖核酸(HBV DNA)、丙氨酸转氨酶(ALT)水平,并采用治疗依从性量表、健康状况调查问卷(SF-36)、焦虑自评量表(SAS)、自我护理能力测定量表(ESCA),评估两组治疗依从性、SF-36、SAS、ESCA评分及不良反应。结果:治疗后4、8、12、24周两组血清HBs Ag、HBV DNA、ALT均较同组干预前明显下降,且研究组上述指标优于对照组(P<0.05);治疗4、8、12、24周,研究组治疗依从性高于对照组(P<0.05);研究组干预后SF-36、ESCA评分均高于对照组,且SAS评分及不良反应明显低于对照组(P<0.05)。结论:以MI为主的沟通模式,可明显提高CHB患者抗HBV-DC诱导治疗依从性,在保证抗病毒疗效同时,改善患者生活质量、不良情绪及自我护理能力,从而减少药物不良反应。
Objective: To investigate the influence of communicative mode based on motivational interview (MI) on the adherence of anti-hepatitis B dendritic cells (HBV-DC) in patients with chronic hepatitis B (CHB). Methods: 120 patients with CHB induced by anti-HBV-DC were randomly divided into study group and control group, with 60 cases in each group. The control group was given routine health education. The study group was given MI-based communication mode, At the beginning of 0, 4, 8, 12 and 24 weeks, the levels of serum HBsAg, HBV DNA and ALT were detected and the treatment compliance scale was used. SF-36, SAS, ESCA, ESCA, SF-36, SAS, ESCA score and adverse reactions were evaluated. Results: Serum levels of HBs Ag, HBV DNA and ALT were significantly lower than those of the control group at 4, 8, 12, and 24 weeks after treatment, and the above indexes in the study group were better than those in the control group (P <0.05) (P <0.05). The scores of SF-36 and ESCA in the study group were higher than those in the control group, and SAS scores and adverse reactions were significantly lower than those in the control group (P <0.05). Conclusion: MI-based communication mode can significantly improve the compliance of anti-HBV-DC induced therapy in patients with CHB, and improve the quality of life, bad mood and self-care ability of patients with adverse drug reactions while ensuring anti-viral efficacy.