在状细胞疾病中药物坚持的障碍:使用COM-B模型进行全面的基于理论的评估
Kathryn King1, Stephanie Cai2, Leonardo Barrera3
1Division of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Pediatric blood & cancer
|May 27, 2023
概括
在状细胞疾病 (SCD) 中,低基尿素的附着性与更多的障碍物有关. 识别这些障碍是改善患者执法和管理SCD并发症的关键.
科学领域:
- 血液学 血液学 血液学
- 药理学 药理学是指药理学的学科.
- 患者坚持的研究研究.
背景情况:
- 状细胞疾病 (SCD) 影响超过10万美国人,导致疼痛和急性胸部综合征.
- 氨酸在减少SCD并发症方面是有效的,但患者的坚持程度较低限制了它的益处.
研究的目的:
- 在SCD患者中调查基尿素粘附的障碍.
- 评估已识别的障碍物和酸粘附水平之间的关系.
主要方法:
- 一项横截面研究招募了使用氧尿素的SCD患者及其护理人员.
- 收集的数据包括人口统计数据,视觉模拟尺度 (VAS) 的坚持,以及疾病管理和障碍面试 (DMI) -SCD,映射到能力,机会,动机和行为 (COM-B) 模型.
主要成果:
- 63%的患者和75%的护理人员通过VAS.报告了低和高的氨酸尿素坚持,分别通过VAS.
- 护理人员将身体机会 (成本) 和反射动机 (SCD感知) 确定为关键障碍.
- 患者报告说,心理能力 (遗忘) 和反思动机是主要障碍.
- 在患者 (r=-.53,p=.01) 和护理人员 (r=-.28,p=.05) 的障碍数和坚持得分之间发现了显著的负相关性.
结论:
- 较少的障碍与SCD中较高的基尿素粘附度相关.
- 了解具体障碍对于开发有针对性的干预措施来改善药物坚持和患者结果至关重要.
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