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目的调查社区共病患者服药依从性,探讨其影响因素,为社区医务人员制定相应的干预措施提供参考依据。方法于2016年5—8月,采用随机抽样方法抽取佛山市顺德区乐从社区卫生服务中心所管理的共病患者907例为调查对象,调查社会人口学资料和疾病相关资料,采用中文版8条目Morisky问卷(MMAS-8)调查服药依从性,采用健康状况调查量表(SF-36)中文版其中的总体健康条目评价患者自评健康状况,分析影响共病患者服药依从性的相关影响因素。结果 MMAS-8平均评分为(6.4±1.7)分,其中>6分(依从性好)495例(54.6%),≤6分(依从性差)412例(45.4%)。不同性别、年龄、婚姻状况、居住情况、文化程度、体质指数(BMI)、服药持续时间社区共病患者服药依从性比较,差异均无统计学意义(P>0.05);不同医疗付费方式、工作情况、家庭人均月收入、共病数量、服药种类、自评健康状况社区共病患者服药依从性比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,医疗付费方式[OR=1.384,95%CI(1.161,1.649)]、工作情况[OR=0.463,95%CI(0.324,0.661)]、共病数量[OR=1.771,95%CI(1.467,2.137)]和自评健康状况[OR=1.980,95%CI(1.517,2.583)]与社区共病患者服药依从性有回归关系(P<0.05)。结论社区共病患者服药依从性较差,医疗付费方式、在岗、共病数量多和自评健康状况差是其影响因素,应针对其影响因素和特点进行干预和管理。
Objective To investigate the medication compliance of community comorbid patients and to explore the influencing factors so as to provide reference for community medical staff to formulate corresponding intervention measures. Methods From May to August 2016, 907 comorbid patients managed by Lecong Community Health Service Center in Shunde District of Foshan City were sampled by random sampling method. The socio-demographic and disease-related data were investigated. The Chinese version 8 Entry Morisky Questionnaire (MMAS-8) To investigate drug adherence using the Health Status Survey (SF-36) version of the Chinese version of the overall health article to evaluate patient self-rated health status and to analyze the impact of co-morbid medication compliance related factors . Results The average score of MMAS-8 was (6.4 ± 1.7) points, with> 6 points (good compliance) of 495 cases (54.6%) and ≤6 points (poor compliance) of 412 cases (45.4%). There was no significant difference in medication compliance between community comorbid patients with different sexes, ages, marital status, living conditions, educational level, body mass index (BMI) and medication duration (P> 0.05); different medical payment methods, (P <0.05). There was a significant difference in medication compliance between community comorbid patients with self-rated health status (P <0.05). Multivariate Logistic regression analysis showed that the medical payment method [OR = 1.384,95% CI (1.161,1.649)], work status [OR = 0.463,95% CI (0.324,0.661) , 95% CI (1.467,2.137)] and self-rated health status [OR = 1.980,95% CI (1.517,2.583]] were positively correlated with medication compliance in community comorbid patients (P <0.05). Conclusions Community co-morbidities have poor medication compliance, and the medical payment methods, on-the-job post, comorbidity and poor self-rated health status are the influencing factors. Intervention and management should be made according to the influencing factors and characteristics.