某社区重性精神疾病患者服药依从性及其影响因素分析  

Investigation on medication compliance and its influencing factors among patients with severe mental illness in a community

作　　者：张明晴 郑慧娟 刘寿[1] 党占翠[1] ZHANG Ming-qing;ZHENG Hui-juan;LIU Shou;DANG Zhan-cui(Medical College,Qinghai university,Xining 810000,China)

机构地区：[1]青海大学医学院,青海西宁810000

出　　处：《中国健康教育》2024年第10期947-952,共6页Chinese Journal of Health Education

基　　金：青海大学中青年社会科学重点基金项目(2020-QSY-3);医学院中青年社会科学基金项目(2019-kys-1);2021年青海省“昆仑英才·高端创新创业人才”计划项目。

摘　　要：目的 了解某城郊社区纳入免费救助药计划的重性精神疾病患者的服药依从性现状及其主要影响因素。方法 于2021年3—12月,选取西宁市某城郊社区辖区建立档案的所有非住院重性精神疾病患者及其主要照顾人作为调查对象,调查自觉领取免费救助药的重性精神疾病患者的服药依从性和主要照顾人对其服药所持的态度,以及未领取免费救助药的重性精神疾病患者的未领药原因。采用二元Logistic逐步回归模型分析影响自觉领取免费救助药的重性精神疾病患者服药依从性的因素。结果 纳入免费救助药计划的重性精神疾病患者的自觉领药率为60.2%,服药依从率为80.5%。二元Logistic逐步回归分析结果显示,以男性、完全由患者自理服药、家属愿意理睬患者为参照,女性、家人督促服药、家属不愿意理睬的患者服药依从性均较低,OR值分别为0.076(95%CI:0.015~0.394)、0.123 (95%CI:0.025~0.606)、0.115 (95%CI:0.020~0.656)。51例未领取免费救助药的重性精神疾病患者未领药的主要原因为:患者现在自觉症状不重(72.5%)和觉得吃药没效果、越吃药病越重(25.4%)。结论 重性精神疾病患者的服药依从性主要受性别、主要照顾人的态度影响,故社区精神卫生管理不仅应提高患者的健康管理,还应纳入主要照顾人的健康管理以提高患者的服药依从性。Objective To understand the status quo of medication compliance and its main influencing factors among patients with severe mental illness who were included in free drug program in a suburban community.Methods From March to December 2021,all non-hospitalized patients with severe mental llness and their primary caregivers who had health record in a suburban community jurisdiction in Xining City were selected as subjects.The medication compliance of patients who consciously received free drugs and the attitudes of their primary caregivers towards their medication,as well as the reasons for not receiving free drugs were investigated.Binary logistic stepwise regression model was used to analyze the factors affecting the medication compliance of patients with severe mental illness who consciously received free drugs.Results Among the patients with severe mental illness included in the free drug plan,the percentage of self-conscious medication was 60.2%,and the percentage of medication compliance was 80.5%.The results of binary logistic stepwise regression analysis showed that the medication compliance of patients who were female,taken medicine by family members,or ignored by family members was lower than that of patients who were male,completely took medicine by self,or not ignored by family members.The 0R values were 0.076(95%Cl:0.015-0.394),0.123(95%Cl:0.025-0.606),and 0.115(95%Cl:0.020-0.656).The main reasons of not receiving free medicine in 51 patients were as follows:not feeling serious symptoms(72.5%),feeling ineffective and more serious after taking the medicine(25.4%).Conclusion The medication compliance of patients with severe mental illness is mainly affected by gender and the attitude of the main caregivers.Therefore,community mental health management should not only improve the health management of patients,but also include the health management of their main caregivers to improve the medication compliance of patients.

关 键 词：城镇社区 重性精神疾病 服药依从性 

分 类 号：R193[医药卫生—卫生事业管理]