Studyonthecomplianceoforaltargeteddrugsinpatientswith Non-smallcelllungcancerbasedontheprotectionmotivationtheory

Purpose To explore the status of oral targeted drug compliance in patients with non-small cell lung cancer and to analyze its influencing factors,and to explore th e effect of health education based on protective motivation theory on oral target ed drug compliance in patients with non-small cell lung cancer.Methodology In the first stage,we first use case review analysis to understand the curre nt situation of oral targeted drug compliance in patients with non-small cell lun g cancer,and then use qualitative research to interview stakeholders,including p atients,family members,doctors,nurses by purposeful sampling for understandin g the influencing factors of compliance.Thematic analysis was used to analyze interview data.In the second stage,the research subjects were recruited from a Grade 3A tumor hospital in Linyi.Follow the principle of informed consent,use convenie nce sampling method,the subjects were divided into control group and intervent ion group,with 50 participants in each group.The control group was given hea lth education on the relevant knowledge of conventional drug use.The intervent ion group was provided with drug health guidance program that was developed according to the motivational variables that had influence on the patient’s drug compliance in the theory of protective motivation.Patients in the control group were given knowledge education and follow-up once a month.The main interve ntion contents of the intervention group included the distribution of educational materials based on the theory of protective motivation,We Chat classroom,telep hone return visit,outpatient follow-up and organization of patient and friend exc hange meetings.intervention time was 6 months.The frequency of We Chat class was once every two weeks,the outpatient follow-up was once every two mon ths,the frequency of telephone return visit was once every two weeks within 3months,4-6 months was once every one month,and the organization of patien t friend exchange meeting was 4-6 months was once every one month.The Chi nese version of oral chemotherapeutic compliance scale scores,oral targeted dru g protection motivation questionnaire scores,European cancer research and tissu e quality of life core scale scores were compared.The research data were analy zed by SPSS23.0 statistical software package,T test and chi-square test were us ed to describe and analyze the data;the difference was statistically significant with P <0.05.Results1.Results of case review analysis A retrospective analysis of 116 cases of non-small cell lung cancer(NSCLC)with oral targeted drugs revealed that 77 cases(66.38%)had poor compliance with medication,including(31 cases with missing drugs,40.26%;21 cases with early wit hdrawal,27.27%;12 cases with unauthorized reduction,15.58%;5 cases with unauthori zed addition,6.50%;8 cases without prescribed time,10.39%).2.Qualitative findings A total of 4 subjects and 14 sub-themes related to the compliance of patients with oral targeted drugs were extracted from 22 subjects: negative psychological e xperience(stigma;fear;anxiety;negative response),poor physical condition(cancer-related fatigue;cancer pain;poor memory),lack of information(lack of disease in formation;ineffective response to adverse drug reactions;lack of drug information;l ack of medical insurance,reimbursement policy information),inadequate support sy stems(lack of medical insurance,incomplete family support systems;inadequate so cial support systems).3.Experimental results(1)adherence to medication: the adherence rate of the intervention group after experimental intervention was significantly higher than that of the control group(P <0.05).and the compliance of the intervention group in each experime ntal period was continuously improved,and the data comparison in each period was statistically significant(P <0.05).(2)Protection motivation questionnaire score: the intervention group scored si gnificantly higher at 6 months than the control group,and the difference was stati stically significant compared with the control group(P<0.001).Except for the selfefficacy dimension,the scores of each dimension in the intervention group at 4 an d 6 months were compared with the control group,and the statistical difference of the datawas statistically significant(P<0.001).(3)Quality of life score: six months after taking medicine,the two groups h ad statistically significant differences in overall health status,cognitive function and improvement of symptom area entries(fatigue,nausea,vomiting,pain)(P<0.05).(4)Comparison of adverse events of taking medicine: the incidence of adver se events of taking medicine in the intervention group was significantly lower than that in the control group at 6 months(P <0.05).(5)Comparison of solid tumor efficacy evaluation standard data :6 months after the experimental intervention,the disease control rate in the intervention group was higher than that in the control group,and the difference was statistic ally significant(P<0.05).Conclusions(1)The actual compliance of oral targeted drugs in patients with non-small cell lung cancer is far lower than expected evaluation,and the present situatio n is not optimistic.Compliance of oral targeted drugs in patients with non-smal l cell lung cancer is affected by a variety of factors.The patient’s demand expe ctations do not match the actually obtained support interventions,and their unm et or partially met needs can not be ignored.(2)Health education intervention based on protective motivation theory can strengthen patients’ understanding of the severity and susceptibility of the disea se motivation variables,help them overcome the internal and external obstacles encountered by patients,strengthen their belief that long-term compliance can be nefit,and then improve the confidence of patients with long-term compliance.