基于格林模式对甘肃省居民家庭自我药疗行为的调查研究  

Investigation Study on Family Self-medication Behavior of Residents in Gansu Province Based on PRECEDE-PROCEED Model

作　　者：王芳 刘惠娟 王红娟 罗斌[2] 王少华[3] WANG Fang;LIU Huijuan;WANG Hongjuan;LUO Bin;WANG Shaohua(Dept.of Pharmacy,Gansu Medical College,Gansu Pingliang 744000,China;School of Public Health,Lanzhou University,Lanzhou 730000,China;School of Pharmacy,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]甘肃医学院药学系,甘肃平凉744000 [2]兰州大学公共卫生学院,兰州730000 [3]兰州大学药学院,兰州730000

出　　处：《中国药房》2020年第11期1377-1381,共5页China Pharmacy

基　　金：国家自然科学基金资助项目(No.41405108,No.21472077)。

摘　　要：目的:促进非处方药物(OTC)在居民家庭中的合理使用,并为卫生行政部门相关政策的制订提供依据。方法:采用分层整群抽样方法,以甘肃省4个市常住居民为调查对象,于2019年1月左右采用入户调查的方式面对面发放问卷,收集受访居民基本情况、居民家庭自我药疗行为情况。运用格林模式分析受访居民自我药疗行为的影响因素[倾向因素(包括对OTC的认知水平和对自我药疗的态度)、促成因素和强化因素,以比值比(OR)研究因素与结果的相关性]。采用Epi Data 3.10软件建立数据库,以SPSS 16.0软件进行统计分析。结果:共发放问卷3600份,回收有效问卷3111份,有效回收率为86.4%。81.8%(2541/3106)的受访者近1年有自我用药行为;二元Logistic回归与χ2检验结果显示,女性、起居不规律、未患慢病、家庭月收入低、购买了新型农村合作医疗和城镇居民医保的居民更倾向于自我药疗。倾向因素中,知晓OTC可不凭医师处方在药房购买(OR=1.322)、药品外包装有OTC标识(OR=1.397)、从OTC外包装的标识上不可判断其安全性(OR=0.789)、认为中草药亦有毒副作用(OR=1.750)的居民自我药疗可能性更大;很少清理家庭药箱的居民(OR=0.462)、药品速效高效(OR=0.670)与不良反应(OR=0.688)是自我药疗发生的阻止因素,而药品价格便宜(OR=5.298)是自我药疗行为发生的倾向因素。促成因素中,家中常备药物居民的自我药疗发生率是没有储备的2.997倍,自我药疗方便(OR=1.376)、药店离家近(OR=1.680)、药品质量可信(OR=1.355)对自我药疗行为的发生有促成作用。强化因素中,亲戚朋友建议(OR=3.388)、书籍报刊或电视网络广告(OR=2.043)等对自我药疗行为发生有加强作用。以上因素对居民自我药疗行为的影响均有显著性(P<0.05)。结论:甘肃省居民家庭自我药疗行为普遍,认知水平越高的居民越倾向于自我药疗,药品价格越低越可能发生自我药�OBJECTIVE:To promote rational use of OTC in the family,and to provide reference for the formulation of related policy by health administration department.METHODS:By stratified cluster sampling method,using residents of 4 cities from Gansu province as objects,face-to-face questionnaire household survey was conducted in Jan.2019.The general information of the residents and their family self-medication behaviors were collected,and the influential factors[tendency factors(including cognition of OTC and attitude towards self-medication),contributing factors and strengthening factors,and odds ratio(OR)was used to study the correlation between factors and results]of self-medication behaviors were analyzed by PRECEDE-PROCEED model.Epi Data 3.10 software was used to establish database,and SPSS 16.0 software was adopted to analyze the family self-medication behavior of residents statistically.RESULTS:A total of 3600 questionnaires were sent out,and 3111 valid questionnaires were recovered,with an effective recovery rate of 86.4%.81.8%(2541/3106)of the respondents had selfmedication behavior in the past 1 year.The results of binary Logistic regression andχ2 test showed that female residents,irregular daily life,no chronic disease,low monthly family income,new rural cooperative medical care and urban residents’medical insurance were more inclined to self-medication.In the tendency factors,residents who knew that OTC could be purchased in the pharmacy without the doctor’s prescription(OR=1.322),drug package with OTC logo(OR=1.397)and the Chinese herbal medicine also had toxic side effects(OR=1.750),the possibility of self-medication was greater;the residents who seldom cleaned the family medicine box(OR=0.462),quick and effective drugs(OR=0.670)and ADR(OR=0.688)were the factors that prevent the occurrence of self-medication behavior,while low drug price(OR=5.298)was the tendency factor of self-medication behavior.In the contributing factors,the incidence of self-medication of residents with regular drugs in their home wa

关 键 词：格林模式 甘肃省 居民 非处方药物 自我药疗 影响因素 

分 类 号：R195.1[医药卫生—卫生统计学] R95[医药卫生—卫生事业管理]