Abstract: Objective: To explore the influencing factors and generating mechanisms of intravitreal injection adherence in patients with macular degeneration, so as to provide a theoretical basis for intervention studies to improve patients' adherence, visual outcomes and quality of life. Methods: Based on grounded theory, we interviewed 33 participants to collect data. Then a theoretical framework for the influencing mechanism of intravitreal administration adherence in patients with macular degeneration was established by means of open coding, spindle coding and selective coding. And data mining using the Apriori algorithm in SPSS Modeler was performed to further determine the relationships between the data. Results: Patients with macular degeneration receiving intravitreal injection were found to observe the logical behavioural process of "cause-phenomenon-situational conditions-intervention conditions-action/interaction-results". According to the results, patient-related factors directly influenced their injection compliance, with disease-and treatment-related factors as internal situational factors, and healthcare system and socio-economic factors as external situational factors that could regulate patient adherence. Besides, three pairs of strong rule-based correlates were derived through data mining. Conclusion: Improving patients' adherence to intravitreal injection requires more doctor-patient communication, enhanced health education by medical staff and adequate family support. By establishing a good family and social support environment, we can help patients overcome treatment barriers and improve their knowledge of and confidence in adherence to intravitreal injection therapy.

Key words: macular degeneration; intravitreal injection; grounded theory study; association rule; adherence