冠心病患者负性情绪及用药依从性对医患疗效认同度的影响  

Influence of negative emotion and medication compliance on consistency of physician-patient therapeutic effect evaluation in patients with coronary heart disease

作　　者：徐辉霞[1] 董邢萍[2] 

机构地区：[1]山东省滨州市人民医院病案室,256610 [2]山东省滨州市人民医院干部保健二科,256610

出　　处：《中华现代护理杂志》2013年第16期1874-1877,共4页Chinese Journal of Modern Nursing

摘　　要：目的 研究冠心病患者抑郁和焦虑状态及患者用药依从性对医患疗效评价一致性的影响.方法 选取山东省滨州市人民医院住院治疗的冠心病患者182例,采用抑郁自评量表和焦虑自评量表对患者精神状况进行评估,同时通过询问患者,判定用药依从性并记录出院时医患双方对疗效评价.探讨服药依从性与抑郁、焦虑状态的关系,评价抑郁、焦虑以及用药依从性对医患疗效评价一致性的影响,采用多因素回归分析医患疗效评价一致性的影响因素.结果 共发放问卷182份,回收182份,有效回收率为100％.182例冠心病患者中抑郁患者82例,焦虑患者66例;服药依从性好的患者103例,服药依从性不佳者79例;服药依从性好的患者中抑郁或焦虑检出率低于服药依从性不佳的患者,两组比较差异有统计学意义（x2值分别为34.02,42.07;P ＜0.01）.39.6％的患者不认同医生的疗效判断,多因素Logistic回归分析提示患者的抑郁、焦虑状态以及用药的依从性是影响医患对疗效评价不一致的因素（OR值分别为3.421,3.739,0.248;P＜0.01）.结论 抑郁、焦虑负性情绪能降低患者服药依从性.抑郁、焦虑的负性情绪及用药依从性差是冠心病患者对疗效不认同的影响因素.提高患者服药依从性,改善抑郁和焦虑情绪状态,有助于改善患者对医生疗效判断.Objective To explore the impact of depression and anxiety state and medication compliance on physician-patient efficacy evaluation consistency in patients with coronary heart disease.Methods The mental status of 182 cases with coronary heart disease from People Hospital of Binzhou City of Shandong Province were assessed by self-rating depressing scale and self-rating anxiety scale.Medication compliance was evaluated and consistency of physician-patient therapeutic effect evaluation were recorded.The relationship between the status of depression and anxiety as well as medication compliance was analysed.The influence factors of doctorpatient efficacy evaluation consistency were analyzed by multiple factors regression.Results One hundred and eighty-two questionnaires were distributed and 182 were retrieved with a effective response rate of 100％.Eightytwo patients were in anxiety state and 66 patients suffered from depression.Seventy-nine patients had poor medication compliance and 103 patients had good medication compliance.The detection ratio of depression or anxiety were higher in patients with poor medication compliance（x2 =34.02,42.07,respectively ; P ＜ 0.001）.Seventy-two patients （39.6％） in the hospital disagreed with the doctor＇ s efficacy evaluation.Multi-factor Logistic regression analysis results indicated that depression,anxiety status and medication compliance was the key factors of efficacy evaluation consistency （OR =3.421,3.739 and 0.248,respectively; P ＜ 0.01）.Conclusions The negative emotions of depression and anxiety can reduce patients medication compliance.The depression,anxiety and medication compliance were the influence factors of efficacy evaluation consistency in patients with coronary heart disease.Enhancing patients＇ medication compliance and treating depression and anxiety emotional state can help patients improve the acceptance with doctors＇ efficacy evaluation.

关 键 词：冠心病 抑郁 焦虑 用药依从性 疗效评价 

分 类 号：R541[医药卫生—心血管疾病]