| Objective: To make a thorough inquiry of current situation and time-varying characteristics of treatment compliance in outpatients with gout,and probe into its influence factors for providing empirical evidence for the intervention strategies.Besides,to develop a treatment compliance scale for patients with gout and provide a reliable tool for accurate assessment of treatment compliance.Methods:(1)A preliminary scale was formed through literature review and expert consultation,and during November 2019 to June 2020,the sample of 193 gout patients were selected for questionnaire survey to examine its reliability and validity;(2)114 outpatients with gout who met the criteria were continuously investigated by ecological momentary assessment.The measure began of the acute attack of gout,and treatment compliance inquiry lasted for 12 weeks.Data analysis employed repeated measures analysis of variance and multi-factor generalized linear regression.Results:(1)Through screening and EFA,the final scale consisted of four dimensions and 14 items,including medication compliance,diet compliance,exercise and warm compliance,and smoking cessation and alcohol restriction compliance.The all factors on the scale formed 70.39% of the total variance and its Cronbach’s α was 0.863,test-retest reliability was 0.820.(2)The average treatment compliance score of outpatients with gout was 11.25±0.91,and the differences of average score in treatment compliance and various dimensions at different measurement time points were statistically significant(P<0.05).Treatment compliance showed a downward trend over time,and a downward emergence after the second weekend.(3)The results of multivariate regression analysis showed that the number of affected joints,the tophi,the average monthly income per capita,the degree of pain,and social support were positive factors affecting treatment compliance;the number of joints affected,the tophi and the average monthly income per capita were positive factors affecting medication compliance;age was positive factors affecting diet compliance,self-efficacy level was a negative factor affecting diet compliance;disease knowledge and course were positive factors affecting exercise compliance;the number of joints involved and tophi were positive factors affecting the compliance of smoking cessation and alcohol restriction.Conclusion:(1)The overall level of treatment compliance of patients with gout is relatively poor,and has a gradual downward trend over time since the acute attack period,especially in the second weekend,showing a noticeable downward trend.(2)The treatment compliance of patients with gout is affected by plentiful factors.the positive factors can be improved such as the number of joints involved,tophi,average monthly income,pain level and social support level,besides,the negative factors are self-efficacy which can be improved.In clinical,effective intervention strategies can be formulated according to the time-varying characteristics of treatment compliance of patients with gout,and combined with its main influencing factors to improve treatment compliance.(3)The gout treatment compliance scale for gout patients developed in our study has comprehensive assessment content,meanwhile it meets the requirements of the guidelines and is a reliable and valid tool among group with gout. |
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