心脏移植受者服药依从障碍和干预策略的系统评价

doi:10.3761/j.issn.0254-1769.2020.04.011

摘要/Abstract

摘要： 目的对心脏移植受者服药依从障碍和干预策略进行系统评价,为心脏移植科室的护理人员制订护理措施提供循证依据。方法检索Cochrane Library、PubMed、Embase、Science Direct、CINAHL、乔安娜布里格斯数据库、中国知网、万方数据库,检索时限为2008年1月—2019年1月,筛选文献、评价纳入研究偏倚风险后,采用内容分析法对结果进行描述性分析。结果共纳入23篇文献,包括9篇横断面研究、6篇队列研究、3篇纵向研究、3篇前后对照研究以及2篇随机对照试验。心脏移植受者服药不依从率为9.0%~70.0%,服药依从障碍包括个人因素、疾病相关因素、社会经济因素。干预措施涉及简化用药方案、认知教育、行为干预、情感支持等。结论青少年、存在内疚负罪感、社会支持度差、社会经济地位低等是心脏移植受者服药依从障碍的影响因素,积极识别依从障碍因素、制订个性化综合干预策略对提高患者的依从性十分重要。

关键词: 心脏移植, 服药依从性, 影响因素分析, 系统评价, 护理

Abstract: Objective To synthesize the best available evidence regarding managing barriers and medication adherence in patients underwent heart transplant. Methods Studies from January 2008 to December 2019 in Cochrane Library,PubMed,Embase,ScienceDirect,CIHNAL,JBI,CNKI,and Wangfang Data,were searched. Content analysis was used for descriptive analysis after screening and appraising. Result Totally 23 articles were included,including 9 cross-sectional studies,6 cohort studies,3 longitudinal studies,3 before-after studies and 2 RCTs. The rates of Medication nonadherence in heart transplant recipients ranged from 9% to 70%. Barriers to medication adherence included individual patient-related factors,disease-related factors,socioeconomic factors. Interventions included medication plan,cognitive education,behavioral intervention,emotional support,etc. Conclusion Adolescents,feelings of remorse and guilt,poor social support and lower socioeconomic status and so forth were barriers for medication adherence. It is of great importance to identify barriers,and design tailored interventions to improve adherence.

Key words: Heart Transplant, Medication Adherence, Root Cause Analysis, Systematic Review, Nursing Care

弓宸, 代琦, 史润泽, 仝贝贝, 康晓凤. 心脏移植受者服药依从障碍和干预策略的系统评价[J]. 中华护理杂志, 2020, 55(4): 535-541.

GONG Chen, DAI Qi, SHI Runze, TONG Beibei, KANG Xiaofeng. Systematic review on managing barriers and intervention of medication adherence in heart transplant recipients[J]. Chinese Journal of Nursing, 2020, 55(4): 535-541.

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