| 吴晓露.基于结构方程模型的慢性心力衰竭服药依从性影响因素分析[J].上海护理,2025,25(5): |
| 基于结构方程模型的慢性心力衰竭服药依从性影响因素分析 |
| Analysis of influencing factors of medication compliance in chronic heart failure based on structural equation model |
| DOI： |
| 中文关键词: 慢性心衰 结构方程模型 服药依从性 |
| 英文关键词:Chronic heart failure Structural equation model Medication adherence |
| 基金项目:吉安市科技计划指导性项目,项目编号:20233-043857 |
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| 中文摘要: |
| 目的：探讨基于结构方程模型分析慢性心衰（CHF）患者服药依从性与医疗、患者、疾病、治疗及经济负担五者之间的关系。方法：选取2023年5月-2024年5月井冈山大学附属医院收治的300例经治疗达到稳定状态并顺利出院的CHF患者为研究对象。采用一般资料调查表、Morisky服药依从性（MMAS）量表、害怕与专业帮助人员亲密（FIS-HP）量表、心力衰竭自我护理行为（EHFSc BS）量表、经济负担综合评分（COST）量表进行调查，采用结构方程模型进行路径分析。结果：CHF患者的MMAS、FIS-HP、EHFSc BS得分为（5.23±1.67）分、（48.19±11.72）分、（40.24±4.87）分，CHF患者自我护理能力与服药依从性呈负相关（P<0.05），医疗团队亲密程度、疾病、治疗及经济负担与服药依从性呈正相关（P<0.05），结构方程模型拟合良好（x2/df=2.444，RMSEA=0.069，GFI=0.978＞0.9，AGFI=0.943＞0.9，路径结果分析发现：患者自我护理能力、医疗团队相关因素、合并慢性疾病数、用药类别和数量、社会经济对服药依从性有直接影响（路径系数分别为-0.147、0.108、0.149、0.191、0.364，均P<0.05）；经济负担因素对服药依从性有间接影响（路径系数为0.364，P<0.05），其中患者自我护理能力、医疗团队相关因素起部分中介作用，两者的中介效应分别为总效应的7.32%、11.94%。结论：患者自我护理能力、医疗团队相关因素、合并慢性疾病数、用药类别和数量、经济负担对CHF患者服药依从性有直接影响，其中患者自我护理能力与CHF患者服药依从性呈负相关，临床工作中可根据CHF患者制定相应方案提高患者服药依从性。 |
| 英文摘要: |
| Objective：To explore the relationship between medication compliance of patients with chronic heart failure(CHF)and economical burden,patients,disease,treatment and socioeconomic factors based on structural equation model.Methods：A total of 300 CHF patients admitted to the Affiliated Hospital of Jinggangshan University from May 2023 to May 2024 who achieved stable state after treatment and were discharged successfully were selected as the study objects.General data questionnaire,morisky medication compliance(MMAS)scale,fear of intimacy with professional help(FIS-HP)scale,economic burden comprehensive score(COST)scale,heart failure self-care behavior(EHFSc BS)scale were used to investigate,and structural equation model was used for path analysis.Results：The scores of MMAS,FIS-HP,COSTand EHFSc in CHF patients were(5.23±1.67)points,(48.19±11.72)points,(29.69±10.55)points and(40.24±4.87)points,and the self-care ability of CHF patients was negatively correlated with medication compliance(P<0.05).The closeness of medical team,disease,treatment and social economy were positively correlated with medication compliance(P<0.05),and the structural equation model was well fitted (x2/df=2.444,RMSEA=0.069,GFI=0.978>0.9,AGFI=0.943>0.9).The path result analysis showed that:Patients’ self-care ability,medical team related factors, number of chronic diseases,type and quantity of medication,and social economy had direct effects on medication compliance (path coefficients were -0.147,0.108,0.149,0.191,0.364,all P<0.05).Social and economic factors had an indirect effect on medication compliance (path coefficient was 0.364,P<0.05),among which patients’ self-care ability and medical team related factors played a partial mediating role,and the mediating effect of the two factors was 7.32% and 11.94% of the total effect,respectively.Conclusion：Patients’ self-care ability,related factors of medical team,number of chronic diseases,type and quantity of medication,and economical burden have a direct impact on medication compliance of patients with CHF.Among them,patients’ self-care ability is negatively correlated with medication compliance of patients with CHF. In clinical work,corresponding programs can be formulated according to patients with CHF to improve medication compliance. |
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