| Objective: 1.Development an objective evaluation tool to assess treatment adherence for all Chronic Hepatitis B Patients and tested for reliability and validity.2.To investigate the status of treatment adherence of CHB patients and explored the factors affecting adherence.Methods:1.Based on Orem's self-care theory,the indicators pool of the scale were initially constructed through literature research,patient interview and expert consultation.2.Two rounds of Delphi was adopted to score and modify the items and elements according to the experts,which were formed to initial scale.3.With convenience sampling method,200 CHB patients from a hospital in guangzhou were investigated using the initial CHB treatment adherence scale.The method of critical ratio,correlation coefficient,Cronbach's coefficient and factor analysis were used to screen the items to form the final scale and tested for reliability and validity.4.Descriptive statistics,t test,one-way analysis of variance,multiple linear regression were used to preliminarily explore the status and influencing factors of CHB treatment adherence.Results: 1.Delphi method for the initial screening of scale items: The recovery rates of the two rounds of questionnaire were 100% and 89%.The mean value of the two rounds of expert authority coefficient(Cr)was 0.95,and Kendall's W of the two rounds of total scale was 0.25 and 0.29(P < 0.01),respectively.A 31-item scale was initially formed: medication compliance(11 items),regular review(6 items),lifestyle improvement(10 items),and mood and information management(4 items).2.After the method of item screenning,a scale of 24 items was formed,including medication compliance(8 items),regular review(5 items),lifestyle improvement(8 items),mood and information management(3 items).3.Reliability and validity test of scale: construct validity:KMO statistic of 0.750 and Bartlett's test of sphericity with(X2=1404.839,P<0.001)were suitability for factor analysis.The third factor analysis was conducted and 5 common factors with the characteristic root value greater than 1 were extracted,and the contribution rate of the cumulative variance was 50.051%,factor 1 and factor 5 belong to the medication adherence,and were combined after discussion.Content validity: the content validity index(s-cvi)of the total scale is 0.923.Reliability analysis: internal consistency: Cronbach's coefficient of the total scale was 0.772,The total volume table is divided into half reliability 0.614,The retest reliability of the total scale is 0.774.4.Status of treatment adherence of CHB patients: the treatment adherence of all CHB patients was(104.98±8.43),and the scoring rate was 87.5%.The score of medication compliance was the highest(37±3.41),the scoring rate was 92.5%,and the score of emotion and information management was the lowest(11.81±2.66),the scoring rate was 78.7%.One-way analysis of variance showed that the scores of treatment adherence of CHB patients with different gender,age,educational level,monthly family income,medical insurance type,disease type and residence were significantly different(P < 0.05).The results of multiple stepwise regression showed that age and medical insurance type were the influencing factors of medication adherence score,residence,gender,monthly family income and type of medical insurance were the factors influencing the scores of regular review.The degree of education was the factor influencing the score of mood and information management.Conclusion: 1.The research which develop the treatment compliance scale for CHB patients has a good reliability and validity,can reflect the treatment adherence of CHB patients scientifically and objectively.The treatment compliance of CHB patients is in the middle and upper level,should paid attention to the medication compliance management of the older patients,medical insurance with selfpaid,outpatient specific program and the city medical insurance.Focuses more on the regular review management of the people who was women,low monthly income,distant residence,the type of medical insurance with self-paid,the city and government-funded and pay attention to the emotion and information management of patients with low educational level. |
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