| BackgroundLiver transplantation is widely accepted as an effective treatment for end stage liver diseas(ESLD). Immunosuppression must be taken lifetime to prevent rejection and lifestyle must be changed after transplant. These refer to compliance. The compliance is described as'the extent to which a person's behaviour (taking medications, following a recommended diet or executing life-style changes) coincides with medical or health advice'. The compliance in liver transplant recipients is affected by demographic and disease characteristics and socioeconomic status. Non-adherence is associated with poor medical outcomes and low quality of life in transplant recipients. In addition, liver resources can be saved because of good compliance.The prevalence, influencing factors and outcomes of medication compliance in liver transplant recipients have been widely studied overseas. While few published data are available about the compliance in liver transplant recipients in China. ObjectiveTo assess compliance in adult liver transplant recipients, ascertain influencing factors, and provide evidence for clinical nurses to take measures for improving compliance. MethodsQuestionnaires, namely, social demographic variables, questionnaire about compliance after liver transplant, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Multimentional Health Locus of Control scale(MHLC) and Social Support Scale , were used to investigate 46 adult liver transplant recipients (age≥18 yr) longer than six months post-transplantation. Data were analysed with descriptive statistics, T- test, One-Way ANOVA, Pearson correlation, and liner regression, using SPSS11.5 software. P values of less than 0.05 were considered significant.Results⒈The total score of compliance ranged between 24~47 score (mean=40.02±4.79 score) (n=46). The average score of compliance to medication was 3.70±0.37 score, to self-monitoring was 2.24±0.85 score, to good and health lifestyle was 3.30±0.51 score and to follow-up was 3.24±0.80 score.⒉Monofactor analysis⑴The monofactor analysis(n=46) indicated that recipients'marital status (t=-2.20,P=0.033) and occupation (t=-2.08, P=0.044) were two significant factors affecting the compliance of adult liver transplant recipients. Recipients'age (r=0.410,P=0.005), average monthly Per capita family income (r=0.357, P=0.015) were positively correlated with recipients'total compliance. Recipients'post transplant time (r=-0.445, P=0.002) were negatively correlated with recipients'total compliance.⑵The standard score of SAS ranged between 26~53 score (mean=40.00±6.13 score) (n=43), which was significantly higher than norm(t=6.63,P=0.000), but was not correlated with recipients'total compliance (r=-0.240, P=0.121). In addition, 3cases were examined as mild anxiety by SAS and others normal.⑶The standard score of SDS ranged between 25~74 score (mean=45.47±10.67 score) (n=43), which was significantly higher than norm(t=2.22,P=0.032), and was negatively correlated with recipients'total compliance (r=-0.357, P=0.019). In addition, 7 cases were examined as mild depression, 5 cases middle depression, 1 case severe depression and others normal.⑷The score of IHLC ranged between 9~36 score (mean=25.93±5.81 score) (n=41), that of PHLC ranged between 11~36 score (mean=27.80±6.00 score) (n=41) and that of CHLC ranged between 6~29 score (mean=16.56±5.36 score) (n=41). The score of PHLC was positively correlated with recipients'total compliance (r=0.415, P=0.007), while, that of IHLC(r=0.194, P=0.224) and CHLC(r=0.002, P=0.992) were not correlated with recipients'total compliance.⑸The total score of social support ranged between 21~55 score (mean=40.83±8.99 score) (n=41), which was significantly higher than norm(t=4.47,P=0.000), and was positively correlated with recipients'total compliance (r=0.557, P=0.000).⒊Liner regression analysis revealed that the main factors influencing the compliance in adult liver transplant recipients were post transplant time, occupation, the score of PHLC and the total score of social support.Conclusions⒈Liver transplant recipients had good compliance to medication and health lifestyle, but relatively poor compliance to follow-up and self-monitoring.⒉The main factors influencing the compliance in adult liver transplant recipients were post transplant time, occupation, the score of PHLC and the total score of social support.⒊The significance of compliance to good and health lifestyle, to follow-up and to self-monitoring should be emphasized in the full-stage health education to the recipients. Besides, more social support, especially from doctors and nurses, may contribute to improving recipents'compliance. At the same time, more attention should be paid to those recipients with lower social status or longer post transplant time.
|
PDF Full Text Request