The Construction Of Prediction Model Of Adherence On Secondary Prevention With Coronary Heart Disease

Objectives:To develop questionnaire of influential factors about adherence and questionnaire of non-medicine adherence on secondary prevention with coronary heart disease.Then analyze their reliability and validity.To investigate adherence to secondary prevention with coronary heart disease, explore the predictors of adherence to medicine and non-medcine and build Prediction Model. Methods:1.The influential factors questionnaire was developed based on compliance framework of WHO and theoretical framework of the qualitative study in the earlier stage.The questionnaire of non-medicine adherence was developed based on the guide of secondary prevention.Suggestions from experts had been considered. Explore factor analysis was used to make sure the structure of the questionnaires.The reliability analysis included the Cronbach'? and the validity analysis included content validity and construct validity.2.Subjects were selected from a convenience sample that outpatient and inpatients with coronary heart disease during August to December in 2015 in an three level of first-class university affiliated hospital.The questionnaire included the general information questionnaire,the Chinese Revised 8 Item Morisky Medication Adherece Scale(MMAS-8), questionnaire of influential factors about adherence and questionnaire of non-medicine adherence on secondary prevention with Coronary heart disease.Using Epidata 3.1 software for data entry and SPSS 19.0 for data analysis, including descriptive analysis, nonparametic test-rank sum test(Mann- Whitney U test for comparison between two groups, Kruskal-Wallis H test for comparison in more than two groups),Spearman correlation analysis and multiple linear stepwise regression analysis. Results:1.The final influential factors questionnaire comprised 61 items and the Cronbach'? coefficient was 0.905.The questionnaire of non-medicine adherence comprised 12 items and its Cronbach'? coefficient was 0.802.2.Multiple linear stepwise regression analysis for MMAS-8 showed that, marriage(the widowed got lower medicine adherence relatived to the married), cultural degree(high school or above got higher medicine adherence relatived to illiterate), gender, patients after PCI, family responsibility, health education, self-control, after discharge medication knowledge, and forgetfulness were predictors variables of medicine adherence.3.Multiple linear stepwise regression analysis for nonmedcine adherence showed that, professional( technical personnel got higher nonmedcine adherence relatived to the farmers), gender, number of hospitalization, family relationship, easy to get health resources, face view, self-control were predictors variables of nonmedicine adherence. Conclusions:1.The promoting factors of medication adherence included education, PCI, health education after discharge, self-control, medication knowledge.The inhibitors included marital status,male,family responsibility,side effects.2.The promoting factors of non-medication adherence included career,admission,family relationship,access to the promotion of medical resources,self-control. The inhibitors included male and face view.