Abstract
陈玮,雷世光,李杨,安竹,余浪,陈静,杨莉,李亚斐.肺结核患者治疗依从性评分量表应用效果分析[J].Chinese journal of Epidemiology,2016,37(2):263-267
肺结核患者治疗依从性评分量表应用效果分析
Effect of application on Adherence Rating Score Scale in treating patients with tuberculosis
Received:May 18, 2015  
DOI:10.3760/cma.j.issn.0254-6450.2016.02.023
KeyWord: 结核,肺  依从性  量表
English Key Word: Tuberculosis,pulmonary  Compliance  Scale
FundProject:贵州省卫生计生委科研基金(gzwkj2013-1-080)
Author NameAffiliationE-mail
Chen Wei Epidemiology Research Section of Preventive Medicine Department of the Third Military Medical University, Chongqing 400038, China
Guizhou Provincial Center Disease Control and Prevention, Guiyang 550001, China 
 
Lei Shiguang Guizhou Provincial Center Disease Control and Prevention, Guiyang 550001, China  
Li Yang Guizhou Provincial Center Disease Control and Prevention, Guiyang 550001, China  
An Zhu Guizhou Provincial Center Disease Control and Prevention, Guiyang 550001, China  
Yu Lang Chongqing Zhongshan Hospital, Chongqing 400013, China  
Chen Jing Guiyang Pulmonary Hospital, Guiyang 550004, China  
Yang Li Guiyang Pulmonary Hospital, Guiyang 550004, China  
Li Yafei Epidemiology Research Section of Preventive Medicine Department of the Third Military Medical University, Chongqing 400038, China liyafei2008@hotmail.com 
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Abstract:
      目的 分析肺结核患者治疗依从性评分(ARS)量表应用效果。方法 选取贵州省10个县(市、区)2013年11月至2014年5月登记的1 349例肺结核患者,治疗前运用ARS量表进行评分,随访观察患者治疗5月末和6月末(复治患者8月末)[6(8)月末]的复查依从性情况,分析评分结果与患者实际依从性之间的关系。利用单因素和多因素相结合的方法进行分析,P<0.05为差异有统计学意义。结果 5月末依从性复查结果显示,ARS评分≥4者复查时705例依从性较好,249例依从性较差;ARS评分<4者复查时213例依从性较好,182例依从性较差。ARS评分≥4者与ARS评分<4者复查时依从性差异有统计学意义(χ2=51.265,P<0.05)。8月末依从性复查结果显示,ARS评分≥4者复查时637例依从性较好,317例依从性较差;ARS评分<4者复查时193例依从性较好,202例依从性较差。ARS评分≥4者与ARS评分<4者复查时依从性差异有统计学意义(χ2=37.865,P<0.05)。综合分析5月及6(8)月末依从性,结果显示,ARS评分≥4者复查时543例依从性较好,411例复查时依从性较差;ARS评分<4者复查时144例依从性较好,251例复查时依从性较差。ARS评分≥4者与ARS评分<4者复查时依从性差异有统计学意义(χ2=46.802,P<0.05)。二元logistic回归分析显示,ARS评分为患者5月末、6(8)月末和继续期总体依从性的主要影响因素(OR=2.448,95% CI:1.910~3.138;OR=2.139,95% CI:1.678~2.726;OR=2.371,95% CI:1.853~3.034)。结论 ARS量表评分显示的依从性与实际调查的相关性较好,治疗前利用ARS量表对患者进行评分能预估患者治疗依从性,适合贵州省使用。
English Abstract:
      Objective To analyze the application effect of Adherence Rating Score(ARS) scale in the treatment of patients with tuberculosis.Methods A total of 1 349 patients with tuberculosis from November of 2013 to May of 2014 in ten counties of Guizhou province were selected.Before treatment, ARS scale was applied.According to data related to the literature on compliance during the follow-up visits in late May and June(the patients were reviewed in late August), correlation of the evaluation score with the actual compliance was analyzed.Results There were 705 cases with high but 249 cases with low compliance when the ARS score was ≥4, while 213 cases with high compliance and 182 cases with low compliance when the ARS score was<4 in late May.The compliance of cases with ≥4 ARS score was significantly different from those cases with<4 ARS score in May(χ2=51.265, P<0.05).637 cases with high compliance and 317 cases with low compliance when the ARS score was ≥4, and 193 cases with high compliance and 202 cases with low compliance when the ARS score was<4 in June(August), were discovered.The compliance of cases with ≥4 ARS score was significantly different from those cases with<4 ARS score in June(χ2=37.865, P<0.05).Data from the comprehensive analysis, based on May and June(August), showed that there were 543 cases with high compliance and 411 cases with low compliance when the ARS score was ≥4, and 144 cases with high compliance and 251 cases with low compliance when the ARS score was<4 in late May.The compliance of cases with ≥4 ARS score was significantly different from those cases with<4 ARS score(χ2=46.802, P< 0.05).Results from the regression analysis showed that all of the late May, June(August) and continuous treatment periods were the factors influencing the compliance of the patients(OR=2.448, 95% CI:1.910-3.138;OR=2.139, 95% CI:1.678-2.726;OR=2.371, 95% CI:1.853-3.034).Conclusion The compliance based on score ARS scale and the actual investigation were significantly related and the compliance could be evaluated using the score ARS scale before the initiation of treatment and could be applied in Guizhou province.
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