Influence of disease perception and treatment confidence on treatment compliance of adolescents with non-suicidal self-injury tendency
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摘要:
目的 探讨非自杀性自伤倾向青少年患者的治疗依从性及其相关影响因素，分析疾病感知和治疗信心对治疗依从性的作用。 方法 选取2020年10月—2023年11月于绍兴市第七人民医院接受治疗的113例非自杀性自伤倾向青少年患者作为研究对象，调查其治疗依从性得分、疾病感知和治疗信心情况。采用Pearson相关性分析研究疾病感知和治疗信心与治疗依从性的关系，并根据患者的治疗依从性得分将其分为高依从性组和低依从性组，通过多因素logistic回归分析研究影响治疗依从性的相关因素。 结果 37.17%(42/113)的患者治疗依从性较差。高治疗依从性患者的年龄、病程、饮酒史、共患抑郁症、疾病感知、治疗信心、RBANS得分与低治疗依从性患者比较差异均有统计学意义(P < 0.05)；Pearson相关性分析显示，疾病感知与治疗依从性呈负相关关系(r=-0.504，P < 0.001)，治疗信心与治疗依从性呈正相关关系(r=0.518，P < 0.001)。多因素logistic回归分析显示，病程(OR=0.051)、共患抑郁症(OR=0.177)、疾病感知(OR=0.817)、治疗信心(OR=1.905)以及RBANS得分(OR=1.221)均为治疗依从性的影响因素(P < 0.05)。 结论 非自杀性自伤倾向青少年治疗依从性较差，提高患者的疾病感知能力和治疗信心，或能作为改善治疗依从性的关键目标。 Abstract:Objective To investigate the treatment compliance of adolescent patients with non-suicidal self-injury tendency and its related influencing factors, and analyze the effects of disease perception and treatment confidence on treatment compliance. Methods A total of 113 adolescent patients with non-suicidal self-injury tendency who were treated in Shaoxing Seventh People' s Hospital from October 2020 to November 2023 were selected as the research object, and their treatment compliance score, disease perception, and treatment confidence were investigated. Pearson correlation analysis was used to analyze the relationship between disease perception and treatment confidence and treatment compliance, and patients were divided into a high compliance group and a low compliance group according to their treatment compliance scores, and the related factors affecting treatment compliance were analyzed by multivariate logistic regression. Results 37.17% (42/113) patients had poor treatment compliance, and the scores of age, course of disease, drinking history, comorbidity of depression, disease perception, treatment confidence, and RBANS score of patients with high treatment compliance were significantly different from those of patients with low treatment compliance (P < 0.05). Pearson correlation analysis showed that disease perception was negatively correlated with treatment compliance (r=-0.504, P < 0.001), and treatment confidence was positively correlated with treatment compliance (r=0.518, P < 0.001). Multivariate logistic regression analysis showed that the course of disease (OR=0.051), comorbid depression (OR=0.177), disease perception (OR=0.817), confidence in treatment (OR=1.905), and RBANS score (OR=1.221) were the factors that affected the treatment compliance (P < 0.05). Conclusion Teenagers with non-suicidal self-injury tendency have poor treatment compliance, and improving patients' disease perception and treatment confidence may be the key goal of intervention measures to improve treatment compliance. -
表 1 2组非自杀性自伤倾向青少年患者的一般资料比较
Table 1. Comparison of general data between two groups of adolescent patients with non-suicidal self-injury tendencies
项目高依从性组
(n=71)低依从性组
(n=42)统计量 P值 年龄(x±s，岁) 15.26±2.09 14.33±2.31 2.142a 0.035 性别[例(%)] 1.518b 0.218 男 17(23.94) 6(14.29) 女 54(76.06) 36(85.71) 民族[例(%)] 2.361b 0.124 汉族 69(97.18) 38(90.48) 其他 2(2.82) 4(9.52) 病程(x±s，年) 1.52±0.37 1.68±0.29 2.552a 0.012 受教育年限(x±s，年) 9.46±1.53 9.02±1.34 1.599a 0.113 精神疾病家族史[例(%)] 1.576b 0.209 是 5(7.04) 6(14.29) 否 66(92.96) 36(85.71) 独生子女[例(%)] 1.116b 0.291 是 46(64.79) 23(54.76) 否 25(35.21) 19(45.24) 饮酒史[例(%)] 13(18.31) 17(40.48) 6.649b 0.010 吸烟史[例(%)] 9(12.68) 10(23.81) 2.339b 0.126 居住地[例(%)] 1.695b 0.193 城镇 46(64.79) 22(52.38) 农村 25(35.21) 20(47.62) 共患病[例(%)] 抑郁症 20(28.17) 21(50.00) 5.440b 0.020 焦虑症 9(12.68) 7(16.67) 0.346b 0.557 边缘型人格障碍 4(5.63) 5(11.90) 1.416b 0.234 创伤后应激障碍 1(1.41) 3(7.14) 2.541b 0.111 治疗依从性量表(x±s，分) 7.92±0.64 6.11±0.49 16.889a < 0.001 RBANS得分(x±s，分) 83.15±7.11 76.32±8.44 4.401a < 0.001 注：a为t值，b为χ2值。 
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表 2 2组非自杀性自伤倾向青少年患者的疾病感知和治疗信心得分情况比较(x±s，分)
Table 2. Comparison of disease perception and treatment confidence scores between two groups of adolescent patients with non-suicidal self-injury tendencies(x±s, points)
组别 例数 疾病感知 治疗信心 高依从性组 71 54.38±5.81 34.22±4.26 低依从性组 42 63.49±6.05 27.59±4.10 t值 7.850 8.187 P值 < 0.001 < 0.001
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表 3 变量赋值情况
Table 3. Variable assignment
变量 赋值方法 治疗依从性 高依从性=1，低依从性=0 年龄 连续变量，以实际值赋值 病程 连续变量，以实际值赋值 饮酒史 是=1，否=0 共患抑郁症 是=1，否=0 疾病感知 连续变量，以实际值赋值 治疗信心 连续变量，以实际值赋值 RBANS得分 连续变量，以实际值赋值
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表 4 治疗依从性影响因素的多因素logistic回归分析
Table 4. Multivariate logistic regression analysis of factors influencing treatment compliance
变量 B SE Waldχ2 P值 OR值 95% CI 年龄 -0.252 0.199 1.607 0.205 0.777 0.526~1.148 病程 -2.979 1.422 4.386 0.036 0.051 0.003~0.826 饮酒史 -0.073 0.867 0.007 0.933 0.930 0.170~5.090 共患抑郁症 -1.732 0.847 4.178 0.041 0.177 0.034~0.931 疾病感知 -0.203 0.071 8.216 0.004 0.817 0.711~0.938 治疗信心 0.645 0.178 13.053 < 0.001 1.905 1.343~2.703 RBANS得分 0.199 0.090 4.935 0.026 1.221 1.024~1.455
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[1] POUDEL A, LAMICHHANE A, MAGAR K R, et al. Non suicidal self injury and suicidal behavior among adolescents: co-occurrence and associated risk factors[J]. BMC Psychiatry, 2022, 22(1): 96. doi: 10.1186/s12888-022-03763-z [2] WANG Y, ZHOU X, CAO B, et al. The psychological characteristics and risk factors of suicidal attempt among mood disorders adolescents accompany with non-suicidal self-injury: a multi-center study[J]. J Affect Disord, 2022, 298(Pt A): 301-307. [3] SHAO C, WANG X, MA Q, et al. Analysis of risk factors of non-suicidal self-harm behavior in adolescents with depression[J]. Ann Palliat Med, 2021, 10(9): 9607-9613. doi: 10.21037/apm-21-1951 [4] 薛毅, 周小艳, 范征莉, 等. 家庭参与式接纳和承诺疗法在青少年非自杀性自伤患者中的应用[J]. 重庆医学, 2022, 51(7): 1131-1134. doi: 10.3969/j.issn.1671-8348.2022.07.010XUE Y, ZHOU X Y, FAN Z L, et al. Application of family participatory acceptance and commitment therapy in the adolescent patients with non-suicidal self-injury[J]. Chongqing Medicine, 2022, 51(7): 1131-1134. doi: 10.3969/j.issn.1671-8348.2022.07.010 [5] BHATT D L, VADUGANATHAN M, KANDZARI D E, et al. Long-term outcomes after catheter-based renal artery denervation for resistant hypertension: final follow-up of the randomised SYMPLICITY HTN-3 Trial[J]. Lancet, 2022, 400(10361): 1405-1416. doi: 10.1016/S0140-6736(22)01787-1 [6] DOBBER J, LATOUR C, VAN MEIJEL B, et al. Active ingredients and mechanisms of change in motivational interviewing for medication adherence. a mixed methods study of patient-therapist interaction in patients with schizophrenia[J]. Front Psychiatry, 2020, 11: 78. [7] BRIJS J, ARAT S, WESTHOVENS R, et al. Treatment adherence in systemic sclerosis: a cross-sectional study[J]. Musculoskeletal Care, 2019, 17(1): 44-53. doi: 10.1002/msc.1363 [8] ZHAO M, ZHAO J, CHEN J, et al. The relationship between medication adherence and illness perception in breast cancer patients with adjuvant endocrine therapy: beliefs about medicines as mediators[J]. Support Care Cancer, 2022, 30(12): 10009-10017. doi: 10.1007/s00520-022-07411-w [9] BASIM P, ARGUN D, ÖZDENKAYA Y. Self-reported medication adherence in differentiated thyroid cancer survivors: role of illness perception and medication beliefs[J]. Head Neck, 2021, 43(2): 428-437. doi: 10.1002/hed.26488 [10] PACCHIAROTTI I, KOTZALIDIS G D, MURRU A, et al. Mixed features in depression: the unmet needs of diagnostic and statistical manual of mental disorders fifth edition[J]. Psychiatr Clin North Am, 2020, 43(1): 59-68. doi: 10.1016/j.psc.2019.10.006 [11] GROVER A, OBEROI M. Self-reported Morisky eight item medication adherence scale is a reliable and valid measure of compliance to statins in hyperlipidemic patients in India[J]. Indian Heart J, 2020, 72(4): 319-320. doi: 10.1016/j.ihj.2020.06.016 [12] BROADBENT E, PETRIE K J, MAIN J, et al. The brief illness perception questionnaire[J]. J Psychosom Res, 2006, 60(6): 631-637. doi: 10.1016/j.jpsychores.2005.10.020 [13] BRUWER B, EMSLEY R, KIDD M, et al. Psychometric properties of the multidimensional scale of perceived social support in youth[J]. Compr Psychiatry, 2008, 49(2): 195-201. doi: 10.1016/j.comppsych.2007.09.002 [14] FOLESANI F, BELVEDERI MURRI M, BIANCOSINO B, et al. The screen for cognitive impairment in psychiatry in patients with borderline personality disorder[J]. Personal Ment Health, 2022, 16(4): 279-289. doi: 10.1002/pmh.1539 [15] CHENG F, SHI L, WANG S, et al. The relationship between childhood traumatic experience and suicidal tendency in non-suicidal self-injury behavior patients[J]. BMC Psychiatry, 2023, 23(1): 401. doi: 10.1186/s12888-023-04863-0 [16] 夏王斌, 黄春海, 沙建敏, 等. 疾病感知和治疗信心在双相障碍自我报告药物依从性中的作用分析[J]. 临床精神医学杂志, 2023, 33(3): 209-212.XIA W B, HUANG C H, SHA J M, et al. Analysis of the role of disease perception and treatment confidence in self-reported medication adherence in bipolar disorder[J]. Journal of Clinical Psychiatry, 2023, 33(3): 209-212. [17] KALAITZIDIS R G, PANAGIOTOPOULOU T, STAGIKAS D, et al. Arterial stiffness, cognitive dysfunction and adherence to antihypertensive agents. Is there a link to hypertensive patients?[J]. Curr Vasc Pharmacol, 2020, 18(4): 410-417. [18] MOBINI S, ALLAHBAKHSHIAN A, SHABANLOEI R, et al. Illness perception, self-efficacy, and medication adherence in patients with coronary artery disease: a path analysis of conceptual model[J]. SAGE Open Nurs, 2023, 9: 23779608231171772. DOI: 10.1177/237796082311717720. [19] SMOLEN J S, GLADMAN D, MCNEIL H P, et al. Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study[J]. RMD Open, 2019, 5(1): e000585. DOI: 10.1136/rmdopen-2017-000585. [20] 杨皓, 潘宇鸿, 王双, 等. 接纳与承诺疗法对精神分裂症患者病耻感、自我效能及依从性的影响[J]. 中华全科医学, 2024, 22(3): 469-472, 503. doi: 10.16766/j.cnki.issn.1674-4152.003428YANG H, PAN Y H, WANG S, et al. Effect of acceptance and commitment therapy on stigma, self-efficacy, and medication adherence in patients with schizophrenia[J]. Chinese Journal of General Practice, 2024, 22(3): 469-472, 503. doi: 10.16766/j.cnki.issn.1674-4152.003428 [21] LU Z, CHEN M, YAN S, et al. The relationship between depressive mood and non-suicidal self-injury among secondary vocational school students: the moderating role of borderline personality disorder tendencies[J]. Front Psychiatry, 2023, 14: 1187800. DOI: 10.3389/fpsyt.2023.1187800. [22] RUKSAKULPIWAT S, LIU Z, YUE S, et al. The Association among medication beliefs, perception of illness and medication adherence in ischemic stroke patients: a cross-sectional study in China[J]. Patient Prefer Adherence, 2020, 14: 235-247. doi: 10.2147/PPA.S235107 [23] PRICE R B, DUMAN R. Neuroplasticity in cognitive and psychological mechanisms of depression: an integrative model[J]. Mol Psychiatry, 2020, 25(3): 530-543. [24] 赵世苗, 冯虹. 童年创伤、自尊、冲动/攻击性与双相障碍躁狂首发患者症状严重程度及自杀风险的相关性[J]. 中华全科医学, 2023, 21(9): 1559-1562, 1624. doi: 10.16766/j.cnki.issn.1674-4152.003170ZHAO S M, FENG H. Correlation between childhood trauma, self-esteem, impulsivity/aggression and the severity of symptoms and suicide risk in patients with bipolar mania[J]. Chinese Journal of General Practice, 2023, 21(9): 1559-1562, 1624. doi: 10.16766/j.cnki.issn.1674-4152.003170 [25] TOLU S, REZVANI A, KARACAN I, et al. Self-reported medication adherence in patients with ankylosing spondylitis: the role of illness perception and medication beliefs[J]. Arch Rheumatol, 2020, 35(4): 495-505. -
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