基于IMB理论的肺结核患者服药依从性现状及影响因素研究  

A study on the status and influencing factors of medication adherence among pulmonary tuberculosis patients based on the IMB model

作　　者：蔡宇琪 黄珊珊 刘志东[3] 王嘉雯 黄国楼 李观海 陈浩[3] 陈文杰 姜悦 尤心怡 朱洋 曹望楠[5] 陈亮 李菁华 CAI Yuqi;HUANG Shanshan;LIU Zhidong;WANG Jiawen;HUANG Guolou;LI Guanhai;CHEN Hao;CHEN Wenjie;JIANG Yue;YOU Xinyi;ZHU Yang;CAO Wangnan;CHEN Liang;LI Jinghua(School of Public Health,Sun Yat-sen University,Guangzhou 510080,China;Centre for Tuberculosis Control of Guang-dong Province;Huizhou Hospital for Occupational Disease Prevention and Treatment;School of Medicine,Jinan Uni-versity;School of Public Health,Peking University;Guangdong Provincial Institute of Public Health;Center for Global Health Research,Sun Yat-sen University)

机构地区：[1]中山大学公共卫生学院,广东广州510080 [2]广东省结核病控制中心 [3]惠州市职业病防治院 [4]暨南大学基础医学与公共卫生学院 [5]北京大学公共卫生学院 [6]广东省公共卫生研究院 [7]中山大学全球卫生研究中心

出　　处：《华南预防医学》2024年第5期390-394,共5页South China Journal of Preventive Medicine

基　　金：广东省医学科学技术研究基金项目(C2020045);广州市基础研究计划基础与应用基础研究项目(202201011330)。

摘　　要：目的了解惠州市肺结核患者服药依从性的现状并探究其影响因素。方法基于信息-动机-行为技巧模型(information-motivation-behavioral skills model,IMB)设计调查问卷。采用方便抽样法,于2022年3—4月在惠州市结核病防治研究院招募肺结核患者为调查对象,调查其治疗期间的服药依从情况,使用logistic回归模型对服药依从性进行影响因素分析。结果269例调查对象中,平均年龄为(46.64±16.47)岁,男性171例(63.6%),女性98例(36.4%)。肺结核患者服药依从率为83.6%(225/269)。多因素logistic回归模型分析结果显示,治疗依从相关知识了解程度越高(OR=1.19)、自我效能越强(OR=2.91)患者服药依从性越好;障碍感知程度越高(OR=0.76)患者服药依从性越差。结论惠州市结核病患者的服药依从性整体较好,主要影响因素为对治疗信息的了解程度、自我效能及障碍感知。加强对患者的健康教育以及医患沟通等干预措施可提高患者的服药依从性。Objective To understand the medication adherence of pulmonary tuberculosis patients in Huizhou City,and explore its influencing factors.Methods A survey questionnaire was developed based on the Information-Motivation-Behavioral skills model(IMB).Convenience sampling was utilized to recruit participants from Huizhou Tuberculosis Prevention and Control Research Institute from March to April 2022 to examine their medication adherence during treatment.A logistic regression model was employed to analyze the factors influencing medication adherence.Results Among the 269 participants,the mean age was(46.64±16.47)years old,with 171 males(63.6%)and 98 females(36.4%).The medication adherence rate was 83.6%(225/269).The results of the multivariate logistic regression analysis revealed that a higher level of knowledge regarding treatment information(OR=1.19)and self-efficacy(OR=2.91)were associated with improved medication adherence among patients.Conversely,a higher level of perceived barriers(OR=0.76)was linked to poorer medication adherence in patients.Conclusions The medication adherence of pulmonary tuberculosis patients in Huizhou City is good overall,and the main influencing factors are the level of knowledge regarding treatment information,self-efficacy,and perceived barriers.In the future,interventions such as health education and doctor-patient communication can be strengthened to improve patients'medication adherence.

关 键 词：肺结核 IMB模型 服药依从性 

分 类 号：R183.3[医药卫生—流行病学]