Acute pancreatitis is one high-incidence acute abdominal condition, which is closely related to dietary habits and lifestyle. Patients' compliance with medical advice also directly affects treatment effect and prognosis. There are some studies on compliance in patients with acute pancreatitis, but little attention has been paid to its association with recurrence.
To investigate the factors associated with compliance with medical advice and the association between compliance and recurrence in patients with acute pancreatitis.
By use of convenience sampling, four grade A tertiary hospitals in Shijiazhuang City (The First Hospital of Hebei Medical University, the Second Hospital of Hebei Medical University, the Third Hospital of Hebei Medical University, and the Fourth Hospital of Hebei Medical University) were selected as survey settings, in which patients with acute pancreatitis treated from 2019 to 2021 were selected as the subjects. Then the patients were surveyed using a self-designed questionnaire for investigating their demographics, awareness level of acute pancreatitis, and health belief during the three days prior to discharge, and were followed up by telephone at 3, 6, and 12 months after the questionnaire survey for acquiring the recurrence. They also attended another survey using a self-designed questionnaire at the last telephone follow-up for understanding their compliance.
In all, 100 cases attended the survey, 97 of them (97.0%) who effectively responded to the survey were included for final analysis. Among the 97 respondents, 62 (63.9%) were fully compliant, 27 (27.8%) partially compliant, and 8 (8.3%) non-compliant. Multivariate Logistic regression analysis showed that gender〔OR=9.393, 95%CI (1.909, 46.223) 〕, age〔OR=1.048, 95%CI (1.000, 1.099) 〕, education level 〔OR=0.572, 95%CI (0.333, 0.985) 〕, and awareness level of acute pancreatitis〔OR=0.902, 95%CI (0.834, 0.976) 〕 were associated with compliance in patients with acute pancreatitis (P<0.05) . During the 12 months of follow-up, 41 patients (42.3%) relapsed and 56 (57.7%) did not. There was a statistically significant difference in compliance of patients with and without recurrence (χ2=7.082, P=0.029) . Multivariate Logistic regression analysis showed that male 〔OR=10.798, 95%CI (1.034, 112.781) 〕, alcohol consumption〔OR=16.546, 95%CI (1.310, 209.049) 〕, cholelithiasis〔OR=8.502, 95%CI (1.694, 42.673) 〕, hyperlipidemia〔OR=5.287, 95%CI (1.098, 25.450) 〕, partial compliance〔OR=0.115, 95%CI (0.014, 0.947) 〕, and noncompliance〔OR=0.036, 95%CI (0.003, 0.513) 〕 were risk factors for the recurrence of acute pancreatitis (P<0.05) .
The factors affecting the compliance of patients with acute pancreatitis include gender, age, educational level, and awareness of acute pancreatitis, and compliance may be a key associated factor of the recurrence rate. Therefore, to reduce the development and recurrence of acute pancreatitis, it is suggested to take actions in accordance with the associated factors of compliance to promote relevant health education to improve patients' compliance with medical advice and ability of self-management. In addition, actions should be taken to reduce the influence of risk factors of recurrence of acute pancreatitis, such as improving unhealthy eating habits, quitting drinking, actively treating hyperlipidemia and other underlying diseases, and curing cholelithiasis and other predisposing factors as soon as possible.
In recent years, with the increase of academic pressure, it is common for high school students to stay up late, eat and rest irregularly, leading to gradually increased yearly incidence of irritable bowel syndrome (IBS) in this population. IBS has a long course, long-term recurrent symptoms and unsatisfactory treatment effects, seriously affecting patients' quality of life, and causing socioeconomic burden of IBS.
To examine the prevalence, epidemiology, and risk factors of IBS in senior high school students, to provide a scientific basis for formulating practical and feasible IBS treatment plans for this group.
An epidemiological questionnaire survey was conducted with acluster random sample of senior high school students in Shanghai, Qinghai, Henan and Macao from July to August in 2020. The questionnaire includes demographic information, the prevalence of IBS, mental health, sleep habits, living habits and other relevant information. The Rome Ⅳ Criteria for IBS were used to diagnose IBS. The Symptom Checklist-90 (SCL-90) was used to assess mental problems and symptoms. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. SPSS 21.0 was used for the analysis of risk factors of IBS.
A total of 5 046 cases attended the survey, 4 793 (95.00%) of them who returned effective questionnaires were included for final analysis. The prevalence of IBS was 4.50% (217/4 793) . It was found that higher grade, depression, anxiety, sensitive interpersonal relationships, eating spicy food, skipping meals, drinking alcohol, excessively bright and noisy sleep environment, poor and very poor sleep quality, sleeping latency≥ 15 min, sleeping time per night ≤7 h, taking hypnotic drugs, daytime disturbance and total PSQI score ≥7 points were associated with increased risks of IBS (P<0.05) .
IBS is a common and frequently-occurring disease among senior high school students. Regular diet, learning to relieve anxiety appropriately, and good sleep quality will contribute to lowering the probability of IBS.
