摘要
目的探讨基于知信行干预理论(KAP)的药学服务模式在系统性红斑狼疮患者(SLE)中的实施效果,为药师开展SLE患者治疗管理服务提供参考。方法纳入SLE患者350例,通过问卷调查和临床检验指标,分析患者KAP与风险感知、疾病活动及脏器损伤的相关性。将患者随机分为干预组和对照组,对干预组患者实施9个月的基于KAP干预理论的药学服务。分析2组患者干预前及干预不同时间后的KAP水平,评价2组患者的疾病控制效果和脏器损伤指数。结果排除资料不全患者26例,324例SLE患者的KAP水平与风险感知正相关,与疾病活动、脏器损伤存在负相关。实施为期9个月的干预后,最终纳入分析302例,其中干预组148例(排除14例),对照组154例(排除8例)。在干预3,6,9个月后,干预组患者KAP各维度在预设时间点的得分均高于对照组(P<0.01);时间效应及分组效应差异有统计学意义(P<0.01)。与对照组比较,干预9个月后,干预组患者的急性发作发生率和不良反应发生率明显降低,风险感知水平、疾病控制效果和脏器损伤情况显著改善(P<0.05)。结论基于KAP干预理论为SLE患者提供针对性的药学服务,有助于其改变行为倾向并促进其进行疾病自我管理,从而提高药学服务质量和疾病控制效果。
Objective To discuss the implementation effect of the pharmaceutical care model based on the knowledge-attitude-practice(KAP)intervention theory among systemic lupus erythematosus(SLE)patients,and to provide a reference for developing therapy management services for SLE patients.Methods A total of 350 patients were included in the study.The correlations of their KAP levels with risk perception,disease activity,and organ damage were analyzed through the questionnaire survey and clinical test indexes.The patients were randomly divided into the intervention group and control group.The patient in the intervention group was given pharmaceutical care based on the KAP intervention theory until discontinued or followed up for nine months.The KAP levels before the intervention and those at pre-designed time points after the intervention were analyzed.Then,SLE disease activity and SLE-related organ damage were evaluated.Results Excluding 26 patients with incomplete data,the KAP levels were positively correlated with risk perception and negatively correlated with disease activity and organ damage in 324 SLE patients.After nine months of intervention,302 patients were included in the analysis,including 148 patients(14 excluded)in the intervention group and 154 patients(8 excluded)in the control group.After 3,6,and 9 months of the intervention,the scores of each KAP dimension at pre-designed time points in the intervention group were all significantly higher than those of the control group(P<0.01).The time and grouping effects were statistically significant(P<0.01).After nine months of intervention,the incidence of acute attacks and adverse reactions in the intervention group were significantly reduced,and the level of risk perception,disease activity,and organ injury was all significantly improved compared with the control group(P<0.05).Conclusion Providing the SLE patients with proper pharmaceutical care based on the KAP theory was instrumental in changing their behavioral tendency and contributed to facilitating their disease self-management to improve the pharmaceutical care quality and disease control effect.
作者
张春歌
唐婕
龚银华
吴憩
ZHANG Chunge;TANG Jie;GONG Yinhua;WU Qi(Department of Pharmacy,the First Affiliated Hospital of Soochow University,Suzhou 215000,China)
出处
《医药导报》
CAS
北大核心
2023年第1期107-113,共7页
Herald of Medicine
基金
苏州市科技局科研项目资助(SYSD2019177,SKJY2021057)。
关键词
知信行
药学服务
系统性红斑狼疮
效果评价
Knowledge-attitude-practice
Pharmaceutical care
Systemic lupus erythematosus
Effect evaluation
