Self-efficacy Intervention On The Compliance Of Liver Transplant Recipients In The Hospital

Text：【Objectives】（1） To identify the compliance and self-efficacy level of patients after livertransplantation.（2） To analyze the factors this may influence the self-efficacy level and complianceafter liver transplantation according to the personal basic information.（3） To analyze the relativity between the compliance and the self-efficacy level ofpatients after liver transplantation, so as to provide a new approach to improvethe compliance of patients after operation.（4） To explore that the intervention effects self-efficacy and compliance in thehospitalization period.【Methods】There are two parts in this study: the first one is a descriptive design. FromOct.2011to May2012,160postoperative of liver transplantation were investigated inthe People’s Liberation Army (PLA)302Hospital liver transplant centers. All subjectscompleted the general information、self-efficacy and compliance after operation.Analysis was made of the postoperative self-efficacy and compliance factors as well asthe variations of them. The second part is a experiment design. From Oct.1.2012toSeptember.30.2013, there are50cases of liver transplant in PLA302Hospital livertransplant centers involved in the study. The patients were divided into2groups atrandom according to the priority order, which are control group and intervention group.Control group was received conventional nursing care and health education afteroperation and the intervention group received the nursing care which can improve theself-efficacy. General information collected using the patient’s transplant registry system. In the form of questionnaires collected self-efficacy level in the preoperative,as well as the compliance and effects self-efficacy level after one month and sixmonths. The Self-efficacy and compliance of two groups were compared by before andafter the intervention. Analysis the relationship between self-efficacy and compliancein the first month and six months after surgery. Statistical analysis was performed withSPSS13.0.【Results】The first part of investigation results showed:(1) The longer after operation and older the age the worse of self-efficacy. Theresults had a remarkable difference.（P<0.05）(2) The compliance is influenced by the length of time after surgery,postoperative complications and age. The results showed a remarkable difference.（P<0.05）(3) There is a significant correlation in the component scales of compliance afterliver transplantation. General compliance, taking medication, self-monitoring of care,life style and follow-up were positively correlated with self-efficacy (P<0.01). Therewas a positive correlation between the score of compliance and self-efficacycorrelation coefficient was0.94.The second part of investigation results showed:(1) Self-efficacy score: the intervention group is2.49±0.56, the is2.52±0.55, Itwas not an obvious difference between two groups（P>0.05）；In the first month aftersurgery, the intervention group is3.07±0.41. The control group is2.66±0.47. It was anobvious difference between two groups（P<0.01）; In the six month after surgery, theintervention group is3.07±0.32, the control group is2.60±0.45. It was an obviousdifference between two groups（P<0.01）; The scores of self-efficacy in the two groupsof patients before and after intervention were analyzed with repeated measurementanalysis of variance. The results showed that it was an obvious difference between twogroups. Also, with the time going, there are differences between the two groups(P<0.05). (2) Compliance score: In the first month after surgery, the intervention groupis88.04±4.99；the control group is79.08±7.48. In the six month after surgery, theintervention group is86.92±5.03；the control group is78.17±6.55. The scores ofintervention group were higher than the control group in the first and six months incompliance, self-monitoring care and lifestyle. It was an obvious difference betweentwo groups（P<0.01）. The scores of taking medication compliance and followed-upwere not an obvious difference（P>0.05）.(3) The relativity between the compliance and the self-efficacy: in the first andsix months after operation, the compliance and self-efficacy were positively correlated（P<0.01）. The correlation coefficient of Pearson were0.87and0.88.(4)The compliance of the six months after operation is influenced by thepostoperative complications. The results showed a remarkable difference（P<0.05）.【conclusion】There is a close correlation between self-efficacy and compliance. Patients’self-efficacy in liver transplantation can be improved by nursing intervention, as well,the intervention improved the patients’ ability of self-care, promoted health behaviors,improved the compliance in postoperative and the quality of life.