The Study On The Relationship Between Medication Adherence,Empowerment Level And Self-efficacy In Patients With Rheumatoid Arthritis

Objective The purpose of this study was to investigate the status of medication adherence,empowerment level and self-efficacy in patients with rheumatoid arthritis,and analyze its influencing factors.At the same time,the correlation between them is further analyzed.To explore the influence of self-efficacy as an intermediary factor on the drug adherence of rheumatoid arthritis.It is expected to provide a theoretical basis for medical staff to take more targeted measures to improve the empowerment level of patients with rheumatoid arthritis and effectively improve the medication adherence of patients.Methods A total of 230 patients with rheumatoid arthritis admitted to the department of rheumatology and immunology of four grade a hospitals in dalian on June 1,2018,solstice on september 28,2018,were selected by convenient sampling method as the investigation objects,through the establishment of general data questionnaire,Chinese Morisky medication adherence scale(MMAS-8),empowerment perception scale(CV-PPES),Chinese self-efficacy scale-8(ASES-8),cross-sectional survey.The database was established by using Excel software,the data was analyzed by using SPSS 20.0 software,and the structural equation model was constructed by using AMOS software.Descriptive or univariate anova,t test,Pearson correlation analysis,multiple stepwise regression,and path analysis were used to statistically process the data collected.Results 1.Themedication adherence score of patients with rheumatoid arthritis was(4.87 ±1.45),among which the drug was used163 patients with low compliance(<6points)(74.43%);There were statistically significant differences in medication adherence scores of patients with rheumatoid arthritis among different ages,monthly incomes,medical payment methods,whether regular follow-up visits were conducted,whether there were adverse reactions,and the types and course of drugs currently taken(P<0.05).2.The empowerment score of patients with rheumatoid arthritis was(34.70 ±12.05),and all items were classified as(4.63±1.61)points;The self-efficacy score was(42.74 ±17.84),and the items were(5.34±2.229).3.Medication adherence of patients with rheumatoid arthritis is related to the dimensions of empowerment level and self-efficacy.There was a positive correlation(P<0.05)between empowerment level and each dimension and self-efficacy.4.The fitness indexes of the final model of the self-perceived burden structural equation for patients with rheumatoid arthritis are as follows:RMSA=0.025,GFI=0.998,AGFI=0.964,NFI=0.999,TLI=0.998,CFI=1.000,IFI=0.999,indicating that the fitting degree of the model is good and the setting concept of the model is reasonable.Path analysis results showed that the total effect of empowerment level on drug compliance was 0.518,the direct effect was 0.351,and the indirect effect was0.167,that is,the mediating effect between self-efficacy and medication adherence accounted for 32.2% of the total effect.Conclusion 1.The medication adherence of patients with rheumatoid arthritis is at a low level,which is related to the general demographic endowment of patients.Attention should be paid to the differences between materials and disease data,especially for patients over 60 years old,with monthly income less than 1000 yuan,self-expense,no regular re-examination,adverse reactions,more than 3 types of drugs currently used and a disease course of 10 years,whose drug compliance needs to be improved.2.The higher the empowerment level and self-efficacy of patients with rheumatoid arthritis,the higher the medication adherenceof patients.Moreover,regular re-examination,empowerment level and self-efficacy have certain predictive effects on medication adherencee of patients with rheumatoid arthritis.3.Self-efficacy is an intermediate factor between the empowerment level and drug compliance of rheumatoid arthritis disease,and indirectly affect the patient's medication compliance.