| Objective1.To investigate the current status of health literacy,social support,beliefs about medication and medication compliance of ulcerative colitis patients.2.To analyze the factors affected medication compliance of ulcerative colitis patients.3.To explore the relationship among health literacy,social support,beliefs about medication and medication compliance of ulcerative colitis.It is intended to provide a theoretical basis for medical personnel to develop medication compliance intervention measures for patients with ulcerative colitis.MethodsBy convenience sampling method,the study surveyed 350 ulcerative colitis patients in a third-class hospital of Tianjin from July 2019 to December 2019,using general data questionnaire,health literacy scale,social support rating scale,beliefs about medication questionnaire-Specific and Morisky medication adherence scale.SPSS23.0 software was used for data entry and analysis.The general information and the current status of health literacy,social support,medication belief and medication adherece of patients with ulcerative colitis were described by mean,standard deviation,frequency,composition ratio,median and quartile.The scores of medication adherence of ulcerative colitis patients with different demographic data and disease data were analyzed by statistical methods,such as t-test,one-way ANOVA,nonparametric test.The relationship among health literacy,social support,medication belief and medication adherence of ulcerative colitis patients was explored by Pearson or Spearman analysis.Multiple linear regression analysis was used to analyze the influencing factors of medication adherence in patients with ulcerative colitis.The mediating role of medication belief was examined and analyzed successively.Results1.Status of health literacy,social support,medication belief and medication adherence in patients with ulcerative colitis(1)Status of health literacy in patients with ulcerative colitisThe total score of health literacy of patients with ulcerative colitis was(110.77±5.85),which average scores were(4.62±0.01).The mean score of each dimension from high to low was(4.80±0.43)for improving health intention,(4.75±0.36)for information acquisition ability,(4.65±0.22)for communication ability and(3.47±0.81)for financial support intention.(2)Status of social support in patients with ulcerative colitisThe total score of social support was(44.60±6.09),which average scores were(3.19±0.44).The mean score of each dimension from high to low was objective support(3.96±0.88),subjective support(3.25±0.45),and social support utilization(2.58±0.66).(3)Status of medication belief in patients with ulcerative colitisThe total score of medication belief in patients with ulcerative colitis was(8.50±5.96).The score of the necessary belief dimension was(19.97±2.75),the average score was(3.99±0.55).The total score of the worrying belief dimension was(11.47±3.73),the average score was(2.29±0.75).(4)Status of mediaction adherence in patients with ulcerative colitisPatients with ulcerative colitis had good medication adherence(32.3%),medium level of medication adherence(30.9%),and low level of medication compliance(36.9%).The item with the highest score was "did you take all the medicine you should take yesterday? ".The lowestscoring entry was "do you think it’s too much trouble to stick to your schedule?".2.Analysis of medication adherence in patients with ulcerative colitis with different characteristics(1)Comparison of medication adherence scores in patients with ulcerative colitis among different socio-demographic characteristicsThe results of univariate analysis showed that there were statistically significant differences in medication adherence among patients with ulcerative colitis with different gender,age,family locations,educational level,family per capita monthly income,medical expense payment method,smoking status,and drinking status(P<0.05).However,there was no statistically significant difference in medication adherence of patients with ulcerative colitis among ethnic groups,marital status,residence,occupation,work/study status,stress,sleep status,and exercise status(P>0.05).(2)Comparison of medication adherence scores in patients with ulcerative colitis among different disease-related dataThe results of univariate analysis showed that the medication adherence of patients with ulcerative colitis with different clinical types,disease severity and disease course were statistically significant(P<0.05).However,there was no statistically significant difference in medication adherence among patients with ulcerative colitis with different lesion sites,disease stage,family history,surgical conditions,adverse drug reactions,hospitalization times and number of outpatient visits(P>0.05).3.Correlation analysis of health literacy,social support,medication belief and medication adherence in patients with ulcerative colitisCorrelation analysis showed that there was a positive correlation between health literacy and medication adherence in patients with ulcerative colitis(r=0.571,P<0.01).Social support was positively correlated with medication adherence(r=0.552,P<0.01).Medication belief was positively correlated with medication adherence(r=0.832,P<0.01).Health literacy was positively correlated with medication belief(r=0.475,P<0.01).Social support was positively correlated with medication belief(r=0.579,P<0.01).Social support was positively correlated with health literacy(r=0.486,P<0.05).4.Multiple linear regression analysis of medication adherence in patients with ulcerative colitisThe results of multiple linear regression analysis showed that gender,age,family per capita monthly income,clinical type,medication belief and health literacy were the influencing factors of medication adherence in patients with ulcerative colitis(P<0.001),which accounted for 78.3% of the variation.5.Mediating effect analysis results showed that the influence of health literacy and social support on medication adherence of patients with ulcerative colitis was mediated by medication belief and the mediating effect of medication belief was 60.33% and 84.96%.Conclusion1.The health literacy of patients with ulcerative colitis is above the average level.Social support is at medium level;The patients’ medication necessity belief is better than medication concern belief.Medication adherence is not ideal.2.The influencing factors of patients with ulcerative colitis include gender,age,family per capita monthly income,clinical type,medication belief and health literacy.3.There is a correlation between the health literacy,social support,medication belief and medication adherence of patients with ulcerative colitis.The higher the level of patients’ health literacy and social support,the better their medication belief and medication compliance.4.The influence of health literacy and social support on medication adherence of patients with ulcerative colitis was mediated by medication belief,which suggests that health care workers in the treatment and nursing work for ulcerative colitis,should give full consideration to improve patients’ health literacy and the degree of social support,improve its medication beliefs,thus improve medication adherence of patients. |
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