摘要
目的探讨基于ADAPT-ITT模型的服药管理策略对乙型肝炎(简称乙肝)患者服药依从性、自我管理能力、病情控制情况及生活质量的影响。方法选取2023年1—12月联勤保障部队第九一O医院感染科收治的106例乙肝患者为研究对象,按照基线资料均衡可比的原则将患者分为观察组和对照组,各53例,对照组行常规用药管理,观察组实施基于ADAPT-ITT模型的服药管理策略,内容包括评估(A)、决定(D)、适应(A)、制作(P)、专题专家(T)、整合(I)、培训(T)、测试(T)8个方面。干预时间为6个月,记录两组患者干预1个月及6个月后的服药依从率、乙肝表面抗原(HBsAg)转阴率,并比较干预前后两组患者自我管理能力及生活质量改善情况。结果观察组患者干预1个月、3个月及6个月后的服药依从率高于对照组,差异具有统计学意义(P<0.05)。观察组患者干预1个月、3个月及6个月后HBsAg转阴率高于对照组,差异具有统计学意义(P<0.05)。干预前,两组患者自我管理能力及生活质量各维度评分比较差异无统计学意义(P>0.05);干预6个月后,观察组患者自我管理能力及生活质量各维度评分均高于对照组,差异具有统计学意义(P<0.05)。结论基于ADAPT-ITT模型的服药管理策略,可以为慢性乙肝患者提供一个全面、灵活且可持续的干预方案,能有效提升乙肝患者服药依从性及自我管理能力,有助于病情转归,从而改善生活质量。
Objective To explore the effect of medication management strategy based on the ADAPT-ITT model on medication adherence,self-management ability,disease control and quality of life in hepatitis B patients.Methods A total of 106 hepatitis B patients admitted to the Infectious Diseases Department at the 910th Hospital of Joint Logistics Support Force from January to December 2023 were selected as the research subjects.According to the principle of balanced and comparable baseline data,the patients were divided into an observation group and a control group,with 53 cases in each group.The control group received routine medication management,while the observation group implemented a medication management strategy based on the ADAPT-ITT model,which included eight aspects:assessment(A),decision(D),adaptation(A),production(P),topical experts(T),integration(I),training(T),and testing(T).The intervention period was 6 months.The medication adherence rates and hepatitis B surface antigen(HBsAg)negative conversion rate were recorded at 1 month and 6 months post-intervention in both groups.The self-management ability and quality of life improvements of both groups of patients before and after the intervention were compared.Results The medication adherence rates in the observation group were higher than those in the control group at 1 month,3 months and 6 months post-intervention,the differences were statistically significant(P<0.05).The HBsAg negative conversion rates in the observation group were higher than those in the control group at 1 month,3 months and 6 months post-intervention,the differences were statistically significant(P<0.05).Before the intervention,there was no statistically significant difference in the each dimension scores of self-management ability and quality of life between the two groups(P>0.05).The each dimension scores of self-management ability and quality of life in the observation group were higher than those in the control group after 6 months of intervention,the differences were statistically significant(P<0.05).Conclusion The medication management strategy based on the ADAPT-ITT model can offer a comprehensive,flexible,and sustainable intervention plan for patients with chronic hepatitis B.It can effectively improve medication adherence and self-management ability,promote better disease outcomes,and ultimately enhance the quality of life.
作者
徐小龙
邓丽
戴爱玲
郑梅英
程倩倩
周晓卿
XU Xiaolong;DENG Li;DAI Ailing;ZHENG Meiying;CHENG Qianqian;ZHOU Xiaoqing(The 910th Hospital of Joint Logistics Support Force,Quanzhou 362000,China)
出处
《护理实践与研究》
2025年第7期949-955,共7页
Nursing Practice and Research
基金
福建省自然科学基金项目(编号:2016J01419)。
