| Objective:1.To get the idea of the changes of neurological physicians’ knowledge structure in anticoagulation and anticoagulation rate in the patients with atrial fibrillation before and after the training which was provided to neurological physicians on anticoagulation of atrial fibrillation related stroke.2.To discuss the validity and applicability of eight items (Morwasky Medication Adherence Scale, MMAS-8)-Chinese revision Morwasky Medication Adherence Scales, adopting warfarin anticoagulation to the patients with atrial fibrillation after onset of cardiac cerebral embolism.Methods:1. Randomly selected from yangzhou region 4 hospitals in two as training group, nerve of a physician, a total of 25, the other two as control group, there were nerve physician 23. By prospective cohort study, intervention group was provided with special training in anticoagulation for a month. The training was performed as theory knowledge training which included two parts.. The first part was about the necessity of anticoagulation, announcements of anticoagulation, means to improve patients’anticoagulation compliance and lower the anticoagulation expulsion rate, and the change before and after training. The second part was about case analysis about anticoagulation to patients with atrial fibrillation, and to see the change of neurological physicians’knowledge structure and anticoagulation rate before and after the training by questionnaire.2. By convenience sampling, they were selected that 122 patients with atrial fibrillation who were received and cured from June 1,2014 till May 31,2015 in the neurology of Yangzhou First People’s Hospital and were treated with warfarin after onset of cardiac cerebral embolism. The data was collected by outpatient follow-up to the patients with atrial fibrillation treated with Warfarin anticoagulation, with Chinese Revision MMAS-8 as the research tool, and the scale validity could be evaluated by reliability analysis, factor analysis and other related analysis.Results:1. 〤omparison in baseline file between control group and intervention group:There was no significant difference in education, job title and gender (P>0.05), and no statistical significance in the difference in anticoagulation knowledge evaluation between control group and intervention group (P>0.05). After providing intervention group with anticoagulation knowledge training, compared with control group, The intervention group got much difference in anticoagulation knowledge evaluation (P=0.000) before and after the training. ②After special training of anticoagulation, the upgrading range for the physicians with each title from intervention group was as:primary>secondary>senior. ③Comparison in anticoagulation rate: Before anticoagulation training, there was no difference in anticoagulation rate between control group and intervention group (P=0.744), while after anticoagulation training, the anticoagulation rate of intervention group increased obviously more than that of control group(p= 0.044). Analyze on anticoagulation rate within group:after theory training to intervention group (P =0.049) there was statistical significance in anticoagulation rate (P<0.05), while for control group, there was statistical significance in anticoagulation rate (P>0.05).2. The Combach.s% coefficient of Chinese Version MMAS-8 was 0.61, the consistency coefficient between evaluators was 0.91, testretes coefficient was 0.92, face validity was 1.009. Comparing from anticoagulation control and onset rate of anticoagulation complication for different levels of medication compliance in patients, the difference was statistically significant. (P<0.05, P<0.01)Conclusions:1. To provide anticoagulation knowledge training to neurological physicians, it not only optimizes the anticoagulation knowledge structure, but also improves the anticoagulation rate in atrial fibrillation related stroke.2. The reliability and validity of Chinese Version MMAS-8 is good, and can be used to evaluate the medication compliance of the patients with atrial fibrillation treated with Warfarin after onset of cardiac cerebral embolism. |
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