上海市徐汇区社区严重精神障碍患者服药依从性及影响因素分析  

Analysis of Medication Compliance and Influencing Factors of Patients with Severe Mental Disorders in Xuhui District of Shanghai

作　　者：朱万胜 徐妹[1] 周卿[1] 张芬 蔡军[2] Zhu Wansheng;Xu Mei;Zhou Qing;Zhang Fen;Cai Jun(Shanghai Xuhui District Mental Health Center,Shanghai,200232,China;不详)

机构地区：[1]上海市徐汇区精神卫生中心,上海200232 [2]上海交通大学附属精神卫生中心,上海200232

出　　处：《中国初级卫生保健》2025年第4期76-80,共5页Chinese Primary Health Care

基　　金：上海交通大学2024年度“医工交叉研究基金”重点项目(YG2024ZD24);上海市徐汇区公共卫生培育项目(2022XHGWPY-PY09)。

摘　　要：目的:了解上海市徐汇区社区严重精神障碍患者服药依从性现状,探讨患者服药依从性的影响因素。方法:采用随机抽样方法抽取徐汇区13个街(镇)1310例严重精神障碍患者进行问卷调查。调查涉及临床情况、慢性病患病情况和家务活动、吸烟饮酒以及自知力与治疗态度与治疗态度、近3个月服药依从性情况、有无照护者等情况。统计社区严重精神障碍患者服药依从率,并采用单因素分析及logistic回归分析探讨服药依从性的影响因素。结果:1310例严重精神障碍患者服药依从率为80.15%(1050/1310),其中精神分裂症、双相情感障碍、精神发育迟滞伴发精神障碍服药依从率分别为82.76%(816/986)、87.07%(101/116)、63.21%(122/193)。单因素分析结果显示,患者文化程度、诊断、既往住院治疗、是否近一年每周饮酒超过3次、是否每周做家务、是否申请免费服药、患者自知力与治疗态度、有无照护者是患者服药依从性的影响因素(χ^(2)值分别为41.801、42.951、16.090、14.472、3.917、15.730、20.335、5.603,P<0.05)。logistic回归分析结果显示,有照护者、自知力好或者一般、未婚、精神分裂症和双相情感障碍、过去一年每周饮酒3次及以上、每周都做家务、申请过免费服药的患者服药依从性更好(P<0.05)。结论:社区严重精神障碍患者服药依从性受到患者自身、照护者、政策等因素影响,建议相关部门采取针对性的干预措施。OBJECTIVE To investigate the status quo of medication compliance of patients with severe mental disorders in Xuhui District of Shanghai,and to explore the influencing factors of medication compliance.METHODS 1310 patients with severe mental disorders were selected by random sampling method from 13 streets(towns)in Xuhui District for questionnaire investigation.The survey involved general demographic data,clinical status,chronic disease prevalence and housework activities,smoking and drinking,self-awareness and treatment attitude,medication compliance in the past 3 months,and the presence or absence of caregivers.The rate of medication compliance among patients with severe mental disorders was analyzed by univariate and multivariate logistic regression analysis.RESULTS The compliance rate of 1310 patients with severe mental disorders was 80.15%(1050/1310),and the compliance rate of schizophrenia,bipolar disorder and mental retardation with mental disorders was 82.76%(816/986),87.07%(101/116),63.21%(122/193),respectively.Univariate analysis showed that patients’education level,diagnosis,previous hospitalization,whether they drank alcohol more than 3 times a week in the past year,whether they did housework every week,whether they applied for free medication,patients’self-awareness and treatment attitude,and whether there were no caregivers were the influencing factors of patients’medication compliance(χ^(2)=41.801,42.951,16.090,14.472,3.917,15.730,20.335,5.603,P<0.05).Logistic regression analysis showed that patients with caregivers,good or average self-awareness,unmarried,schizophrenia and bipolar disorder,drinking equal to or more than 3 times a week in the past year,doing housework every week,and applying for free medication had better medication compliance(P<0.05).CONCLUSION The medication compliance of patients with severe mental disorders in the community is affected by many factors such as patients themselves,caregivers and policies.It is suggested that relevant departments should take targeted interve

关 键 词：社区 严重精神障碍患者 服药依从性 

分 类 号：R749[医药卫生—神经病学与精神病学]