远程心电监护患者依从性及其相关因素剖析.docVIP

远程心电监护患者依从性及其相关因素剖析 　　[摘要] 目的 探讨影响远程心电监护患者依从性的相关因素，为提高远程心电监护效果提供参考依据。 方法 选取2011年1月～2014年12月在中山市人民医院具有远程心电监护适应证的患者200例，对患者进行远程心电监护仪使用培训，对拒绝参加远程心电监护的患者调查其原因；对于同意参加远程心电监护的患者，调查患者认知、态度，追踪随访其依从性情况，并分析影响因素。 结果 84例在参加完监测仪使用培训后拒绝参加远程心电监护，原因主要为“认为结果干扰大，不准确”（69例，占82.14%）、“加重经济负担，没必要”（58例，占69.05%）、“觉得反馈信息难以理解”（52例，占61.90%）。116例同意参加远程心电监护的患者中，27例（23.3%）依从性差。分析提示，文化程度（P = 0.027）、病程（P = 0.045）、家庭年人均收入（P = 0.026）、住所到随访医院距离（P 0.001）、“认为使用远程实时心电监测增加安全感，可及时发现疾病发作”（P = 0.005）、“认为医护人员已给予足够培训，自己已掌握监护仪操作”（P 0.001）可能影响心电监测患者的依从性。进一步Logistic回归分析显示，住所到随访医院距离（OR：1.951～2.779，P 0.001）、“认为使用远程实时心电监测增加安全感，可及时发现疾病发作”（OR = 3.781，P 0.001）、“认为医护人员已给予足够培训，自己已掌握监护仪操作”（OR = 3.498，P 0.001）是影响心电监测患者依从性的影响因素。 结论 住所到随访医院距离（公里）越远，对监测的目的意义越认可，通过培训掌握监护仪操作，此类患者的依从性较好。应采取针对性措施，提高远程心电监护依从性，确保效果。 　　[关键词] 远程心电监护；依从性；影响因素 　　[中图分类号] R445 [文献标识码] A [文章编号] 1674-4721（2016）09（b）-0108-05 　　[Abstract] Objective To explore the compliance of the remote ECG monitoring patients and its related factors， providing reference for improving the effect of remote ECG monitoring. Methods Two hundred cases of the remote ECG monitoring patients were selected from Zhongshan Peoples Hospital from January 2011 to December 2014 who had remote ECG monitoring indications. They were trained firstly for remote ECG monitor. The patients who refused to join the remote ECG monitoring were surveyed for the reasons， while the patients who agreed to participate in remote ECG monitoring were investigated for the cognition and attitude. Then the compliance was followed up. And the influencing factors were analyzed. Results Eighty-four cases refused to join the remote ECG monitoring. The main reasons were the results are inaccurate （69 cases， 82.14%）， increase the economic burden， it is not necessary （58 cases， 69.05%）， the feedback information is hard to understand （52 cases， 61.90%）. 116 patients agreed to participate in the monitoring， with 27 patients （23.3%） poor compliance. The education level （P = 0.027）， the course of the disease （P =