Correlation Analysis Between Medication Adherence And Illness Perception In Patients With Cirrhosis And Countermeasures Research

Objective To understand the status of medication adherence and illness perception of patients with liver cirrhosis.Analysis of the correlation between general characteristics,illness perception,and medication adherence in patients with cirrhosis was made.The results of qualitative interviews with patients with liver cirrhosis were sorted out.Combining the results of interviews and data analysis,based on the theory of self-regulation,we formed measures to improve the medication adherence of patients with liver cirrhosis.And these measures also can be regarded as reference for the medical management of patients with cirrhosis.Methods The study consists of two parts.Part I is a study on the correlation between illness perception and medication adherence of patients with cirrhosis.In this part,200 patients with cirrhosis who followed up in the hepatology department of a tertiary hospital in Wuhan from December 2018 to August 2019 were selected by convenient sampling method.Revised Chinese Illness Perception Questionnaire(CIPQ-R)and 8-item Morisky Medication Adherence Scale(MMAS-8)were used in patients with cirrhosis to test their illness perception and medication adherence.A self-made questionnaire was used for general data collection.Statistical description,Student's t test,monofactor analysis,correlation analysis and multiple linear regression analysis were performed after questionnaire data recorded into SPSS23.0.Part II is a qualitative study on the perception of medication treatment in patients with liver cirrhosis.In this part,a total of 12 patients with cirrhosis were selected via purposive sampling.Descriptive phenomenology was used for a semi-structured in-depth one-to-one interview with the patients.Colaizzi's seven-step analysis method was used to analyze the collected interview data.Results Correlation study:(1)197 valid questionnaires were collected.The total score of medication adherence of patients with cirrhosis was(6.18±1.50),with 53 patients(26.90%)with high medication adherence,63 patients(31.98%)with medium medication adherence,and 81 patients(41.12%)with low medication adherence.(2)Age,education level,occupational status,interpersonal relationship satisfaction,per capita monthly household income,payment method of medical expenses,frequency of follow-up visits,and whether taking other drugs for other chronic diseases at the same time were significantly correlated with patients' illness perception(p<0.05).Patients with cirrhosis who were satisfied with their interpersonal relationship,didn't have to pay for their own treatment,had more per capita monthly household income,more follow-up visits,and did not take drugs for other chronic diseases at the same time had better medication adherence.(3)There was a significant and strong correlation between the scores of each dimension of the CIPQ-R and the scores of medication adherence(|r|: 0.7~0.9,p < 0.05)in patients with cirrhosis.Time-line(acute/chronic),Consequences,Personal control,Treatment control,Illness coherence,Timeline cyclical and Emotional representations had significant impacts on the medication adherence of patients.There was a significant negative correlation between illness perception and medication adherence in patients with cirrhosis.Qualitative study: Six themes were extracted from the interview with patients with cirrhosis:(1)Lack of relevant knowledge;(2)Patients suffered multiple effects during the treatment;(3)Patients' medication adherence was affected by multiple factors;(4)The importance of being adherent to medical treatment was affirmed;(5)Hope(drugs);(6)Needs(knowledge).Conclusion In this study,the medication adherence of patients with cirrhosis was at a moderate low level.Patients with higher medication adherence have better illness perception.The medication adherence of patients with cirrhosis is affected by a variety of factors,and illness perception plays an important role in the medication adherence of patients.All sectors of society need to pay attention to symptom changes and psychological responses of patients with cirrhosis.By using multiple forms of heath education,patients can form positive illness perception and their medication adherence can also be improved.