哮喘患者吸入性糖皮质激素用药依从性的潜在类别分析  

Latent class analysis of Inhaled Corticosteroids adherence in patients with asthma

作　　者：董瑞莹 孙善文 张静漪 李娟[1] 张晓春[2] DONG Ruiying;SUN Shanwen;ZHANG Jingyi;LI Juan;ZHANG Xiaochun(Department of Cardiovascular Surgery,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,710061,China)

机构地区：[1]西安交通大学第一附属医院心血管外科,西安市710061 [2]中国医科大学附属第一医院呼吸与危重症医学科

出　　处：《中国护理管理》2025年第3期357-363,共7页Chinese Nursing Management

摘　　要：目的:分析成人哮喘患者吸入性糖皮质激素用药依从性的潜在类别特征,为有针对性的用药管理提供依据。方法:2020年10月至2021年10月,采用便利抽样法抽取沈阳市某三级甲等医院399名哮喘患者进行吸入性糖皮质激素用药依从性、服药信念及抑郁症状的问卷调查,通过潜在类别分析法对吸入性糖皮质激素用药依从性进行分类,采用无序多分类Logistic回归分析不同依从性类别的影响因素。结果:哮喘患者吸入性糖皮质激素用药依从性可分为“整体依从性好-无意识不依从倾向型”(52.1%)“、整体依从性一般-混合不依从型”(26.6%)和“整体依从性差-故意不依从倾向型”(21.3%)3个潜在类别,抑郁症状(P<0.001)、必要性信念(P=0.024)及顾虑信念(P=0.005)是吸入性糖皮质激素用药依从性类别的影响因素。结论:哮喘患者吸入性糖皮质激素用药依从性存在群体异质性,抑郁症状、服药信念是依从性类别的影响因素,临床医护人员应评估哮喘患者吸入性糖皮质激素用药依从性类别及心理状况,了解患者的疾病及治疗认知状况,进行有针对性的干预。Objective:To explore the potential categories of Inhaled Corticosteroids(ICS)adherence in adults with asthma,so as to provide a reference for targeted intervention to improve ICS adherence in patients with asthma.Methods:We conducted a questionnaire survey on the medication adherence,medication belief and depression status of 399 patients enrolled by convenience sampling in a tertiary grade A hospital in Shenyang from October 2020 to October 2021.Then latent class analysis was used to classify the ICS adherence.We also employed disordered multi-classification Logistic regression analysis to determine the associated factors of each class.Results:The adherence of ICS in asthma patients could be divided into three potential classes,namely"good overall adherence-unintentional non-adherence tendency type"(52.1%),"moderate overall adherence-mixed non-adherence type"(26.6%)and"poor overall adherence-intentional non-adherence tendency type"(21.3%).Depressive symptoms(P<0.001),necessity beliefs(P=0.024)and concerns beliefs(P=0.005)were the influencing factors of ICS adherence categories.Conclusion:There is significant group heterogeneity in the medication adherence of asthma patients with depressive symptoms and medication beliefs being the influencing factors of adherence categories.Healthcare professionals should evaluate the adherence categories and psychological status of asthma patients,understand the patients'perspectives of their diseases and treatment to carry out targeted interventions.

关 键 词：哮喘 依从性 抑郁 服药信念 潜在类别分析 

分 类 号：R47[医药卫生—护理学] R197[医药卫生—临床医学]