Objective To explore the influencing factors of inhalation medication compliance in Chinese asthma patients, and to provide evidence for improving the compliance of patients with inhalation therapy. Methods PubMed, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were searched for literature on factors influencing inhalation medication compliance in Chinese asthma patients from the establishment of databases to December 2021. Meta-analysis was performed using RevMan 5.2 software. Results A total of 16 studies were included, with a sample size of 2 600 cases, 1 084 cases of good compliance with inhalation administration, 1 516 cases of poor compliance with inhalation administration, and good compliance with inhalation administration accounted for 41.69%. The literature quality evaluation scores were all ≥4 points, all of which were of medium quality and above. Meta-analysis showed that the factors affecting inhalation compliance of asthma patients included age [odds ratio (OR)=0.54, 95% confidence interval (CI) (0.32, 0.91), P=0.02], educational level [OR=0.57, 95%CI (0.36, 0.90), P=0.02], doctor-patient relationship [OR=0.42, 95%CI (0.19, 0.93), P=0.03], disease severity [OR=0.25, 95%CI (0.11, 0.58), P=0.001], degree of mastery of asthma knowledge [OR=2.51, 95%CI (1.11, 5.65), P=0.03], degree of mastery of inhalation technique [OR=8.66, 95%CI (3.20, 23.40), P<0.0001], adverse drug reaction [OR=0.23, 95%CI (0.13, 0.41), P<0.00001]. Conclusion The compliance of inhaled dosing in Chinese asthma patients needs to be improved urgently. Age, education level, doctor-patient relationship, disease severity, mastery of asthma knowledge, mastery of inhalation technology, and adverse drug reactions are the important influencing factors of inhaled medication compliance.
目的 分析华西医院门诊患者对挂号单上就诊信息的知晓和依从情况及其影响因素，以进一步优化就诊流程，提高患者满意度。 方法 将2012年2月5日－2月10日就诊的患者作为调查对象，采用方便抽样法和问卷面对面访谈法对739例就诊者进行调查，并运用R×C列联表χ2检验分析其影响因素。 结果 90.7%的患者能够积极阅读挂号单上的信息，并依照信息顺利就诊。但也有部分患者因文化程度及医院服务疏漏导致无法顺利就诊。 结论 应该加大对文化程度偏低者和老年患者的宣传指导，改进医院服务方式，完善就诊信息系统功能，进一步提高医院服务水平。
目的 探讨心理行为干预对痛风患者遵医行为的影响。 方法 2006年1月－2010年9月，选取痛风患者190例，随机分为干预组和对照组，两组均进行遵医行为评价和疾病相关检查；对干预组进行认知行为干预，分析患者存在的痛风饮食治疗的认知误区，有针对性地进行心理行为干预。 结果 干预后，干预组认知行为总分和各单项分均高于对照组（P＜0.05），胆固醇、甘油三酯和体质量指数均低于对照组（P＜0.05）；干预组19例（20.0%）复发，对照组36例（37.9%）复发，两组复发率比较，差异有统计学意义（χ2=7.390，P=0.007）。 结论 行为认知治疗可提高痛风患者的治疗依从性，从而有助于改善尿酸等相关指标。
ObjectiveTo systematically review the adjuvant endocrine therapy adherence among Chinese patients with breast cancer. MethodsThe Cochrane Library, Web of Science, PubMed, EMbase, CINAHL, CNKI, VIP, WanFang Data and CBM were electronically searched to collect studies on adjuvant endocrine therapy adherence among Chinese patients with breast cancer from inception to September 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 16.0 software. ResultsA total of 24 studies were included. The results of meta-analysis showed that: the overall adherence rate of adjuvant endocrine therapy in Chinese breast cancer patients was 55.0% (95%CI 0.44 to 0.65), and a 5-year adherence rate was 54.4% (95%CI 0.46 to 0.63). Subgroup analysis showed that patients with good disease awareness, high education level, high monthly household income, living in cities, effective family support, no adverse drug reactions, high convenience of seeking medical treatment, regular review, health education, no comorbidities, and changes in medication type might have higher compliance. ConclusionThe adherence rate of adjuvant endocrine therapy in breast cancer patients in China is low. Adherence varies between sociodemographic characteristics, treatment, and social support for breast cancer patients.
Objective To know the present situation of hand hygiene compliance in medical staff and analyze problems in the management of hand hygiene and related influencing factors, in order to take effective control measures and gradually improve hand hygiene compliance in medical staff. Methods Between January and October 2014 and between January and October 2015, 8-10 healthcare workers respectively from Department of Internal Medicine, Department of Surgery and Department of Rehabilitation were selected to be observed. The healthcare workers between January and October 2014 before the application of plan-do-check-action (PDCA) cycle were regarded as the control group, and hand hygiene observation was performed in October 2014; the healthcare workers between January and October 2015 were regarded as the observation group (after PDCA application), and hand hygiene observation was carried out in October 2015. Under the PDCA cycle, we set up hand hygiene management working group to investigate the hand hygiene work before PDCA cycle was applied. Hand hygiene knowledge survey was carried out. Fishbone diagram was used to find out the causes of poor hand hygiene compliance. Based on these factors, improvement plans of hand hygiene were regulated and implemented. Then, continuous improvement was promoted according to PDCA cycle management process. Results After PDCA implementation, healthcare workers’ hand hygiene compliance (79.67%), correct handwashing rate (94.97%), and hand hygiene compliance before contacting the patients (85.96%), before sterile operation (68.14%), after contacting the patients (78.02%), after contacting patients’ blood or body fluid (85.96%), and after contacting patients’ surroundings (79.14%) were all significantly higher than those before the PDCA implementation (46.39%, 69.62%, 38.42%, 23.20%, 49.14%, 53.78% and 48.39%) (P<0.05). After the implementation of PDCA cycle, the amount of disinfectants consumed per day and the amount of hand sanitizer was 10.13 mL, significantly more than that before PDCA implementation (2.8 mL). The hospital was equipped with full hygiene equipment. Conclusion Applying PDCA cycle for continuous improvement of hand hygiene work can promote the hand hygiene compliance for medical staff.
ObjectiveTo systematically evaluate the effects of cognitive behavioural therapy (CBT) on improving depression, medication adherence and quality of life in people living with HIV/AIDS (PLHIV). MethodsWe searched The Cochrane Library (Issue 4, 2013), Ovid-JBI, PubMed, EMbase, PsycARTICLES, CBM and CNKI to collect randomized controlled trials (RCTs) on improving depression, medication adherence and quality of life in PLHIV from the establishment dates to April 30th 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality. Meta-analysis was conducted using RevMan 5.2. ResultsA total of 17 RCTs were included, involving 2 163 patients. The results of meta-analysis showed that CBT significantly improved PLHIV's depression (SMD=-0.26, 95%CI-0.41 to-0.10, P=0.001), and quality of life (SMD=-0.57, 95%CI-1.04 to-0.11, P=0.02) in 6 months. Meanwhile, CBT significantly improved PLHIV's medication adherence (WMD=3.98, 95%CI 1.67 to 6.30, P=0.000 8) in the long term. ConclusionCBT is efficacious in improving PLHIV's depression and quality of life in the short term, and improving medication adherence in the long term, compared to standard care.
目的 评价手卫生健康教育对重症监护病房（ICU）患者家属手卫生依从性的影响。 方法 选取2012年3月－5月ICU患者家属558人，对其进行手卫生健康教育。将健康教育前的1个月定义为第1阶段(基线调查阶段），健康教育当月定义为第2阶段，健康教育结束后的第1个月定义为第3阶段。对ICU患者家属开展手卫生健康教育，第1和第3阶段均采用张贴展板和宣教图片，床旁准备速干手消毒液；第2阶段在此基础上，每周示范六步洗手法3次，由责任护士督促并指导家属使用速干手消毒液进行手卫生。观察3个阶段患者家属手卫生依从性变化情况。 结果 在对“接触患者前”、“接触患者后”和“接触患者周围环境后”3个手卫生时机的依从率比较中，第2阶段明显高于第1阶段（P＜0.01）；第3阶段较第2阶段有明显下降（P＜0.01）；在3个阶段中，使用速干手消毒液进行手卫生的人数均高于使用洗手液的人数。 结论 手卫生健康教育普及了手卫生相关知识，提高了ICU患者家属对手卫生的依从性。
ObjectiveTo explore the effect of programmed family nursing intervention on medication compliance in hypertensive patients. MethodsA total of 160 patients with hypertension treated between August 2012 and July 2013 in our hospital were chosen to be our study subjects. They were randomly divided into two groups:control group (n=80) and trial group (n=80). Patients in the control group were given routine nursing intervention for six months, while those in the trial group received six-month programmed family nursing intervention. Then, we compared the effect of blood pressure control and medication compliance between the two groups. ResultsThe effect of blood pressure control and medication compliance in the trial group after the intervention was better than that in the control group, and the difference was statistically significant (P<0.05). ConclusionThe programmed family nursing intervention is better than the routine nursing intervention in terms of effect of blood pressure control and patients' medication compliance, and it is an effective nursing method for hypertensive patients.
Objective To investigate the medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents and its influence on the prognosis of individuals at high risk of stroke. Methods A total of 16892 residents aged 40 years or above in eight communities in Sichuan participated in a face-to-face study from May to September 2015. A database of a high-risk population of stroke in Sichuan province was established, and data were collected via using a standardized structured questionnaire by experienced investigators, including the treatment status and medication compliance of participants with hypertension, diabetes, or dyslipidemia during the follow-up period. Multiple logistic regression analyses were performed to explore the influencing factors of medication adherence and its influence on the prognosis of individuals at high risk of stroke. Results A total of 2893 participants at high risk of stroke were enrolled. The treatment rates of hypertension, diabetes, and dyslipidemia were 50.1%, 49.2%, and 5.1%, respectively, when the high-risk individuals were identified. At the end of follow-up (with a median follow-up period of 4.8 years), the treatment rates of hypertension, diabetes, and dyslipidemia were 24.8%, 25.0%, and 7.9%, respectively. Medication adherence to antihypertensives, antidiabetics, and lipid-lowering agents were 27.8%, 25.5%, and 18.1%, respectively. Multiple logistic regression analyses showed that the education level of high school or above [odds ratio (OR)=2.134, 95% confidence interval (CI) (1.098, 4.147), P=0.025], medical insurance for urban residents [OR=1.556, 95%CI (1.086, 2.230), P=0.016] and urban employees [OR=2.325, 95%CI (1.362, 3.967), P=0.002], having fewer children [OR=0.819, 95%CI (0.719, 0.933), P=0.003], and family history of stroke [OR=1.559, 95%CI (1.066, 2.282), P=0.022] were associated with greater adherence to antihypertensives; medical insurance for urban employees was associated with greater adherence to antidiabetics [OR=2.494, 95%CI (1.173, 5.300), P=0.018]. After adjusting for confounding factors, failure to regular use of antihypertensives [OR=2.617, 95%CI (1.414, 4.842), P=0.002], antidiabetics [OR=3.909, 95%CI (2.394, 6.380), P<0.001], and lipid-lowering agents [OR=4.828, 95%CI (2.581, 9.033), P<0.001] in patients with hypertension, diabetes, and dyslipidemia, respectively were associated with increased risk of ischemic stroke during the follow-up period. Regular use of lipid-lowering agents in patients with dyslipidemia was associated with an increased risk of intracerebral hemorrhage during the follow-up [OR=4.371, 95%CI (1.156, 16.530), P=0.030]. Conclusions The prevalences of hypertension, diabetes, and dyslipidemia are high in high-risk individuals of stroke in Sichuan province. However, the treatment rates are unsatisfactory, and the medication adherence is poor. The medication adherence is affected by a variety of demographic and socioeconomic factors. Regular treatments of hypertension, diabetes, and dyslipidemia reduce the risk of ischemic stroke in individuals at high risk of stroke, but regular use of lipid-lowering agents in patients with dyslipidemia is associated with an increased risk of intracerebral hemorrhage during the follow-up.