社区老年高血压患者用药依从性与主观幸福感相关性分析
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摘要
目的:了解社区老年高血压患者用药依从性与主观幸福感现状,并探讨两者的相关性。方法:采用MORISKY推荐的用药依从性量表、纽芬兰纪念大学幸福感量表(MUNSN)对随机抽取的333名社区老年高血压患者进行调查分析。结果:社区老年高血压患者用药依从性优者96人(28.8%),中者183人(55.0%),差者54人(16.2%)。主观幸福感得分(32.67±6.02)。主观幸福感和正性因子与用药依从性呈正相关,负性因子与用药依从性呈负相关。正性因子越高、文化程度越高,年龄在70岁以下的患者用药依从性越好。结论:社区老年高血压患者用药依从性偏低,主观幸福感处于中等水平,用药依从性与主观幸福感密切相关,尤其是正性因子。增强患者主观幸福感可提高其用药依从性。
Objective:To explore the current status and correlation of medication compliance and subjective sense of well-being of elder patients with hypertension in community.Methods:333 elder patients with hypertension in community were surveyed with medication compliance scale proposed by MORISKY and MUNSH. Results:96 cases(28.8%)of the patients showed good compliance while 183 cases(55.0%) showed medium complianceand 54 cases(16.2%)showedpoor compliance.The subjective sense score of well-being was(32.67±6.02).Subjective sense of well-being and positive factors were positively correlated with medication compliance. Negative factors were negatively correlated with medication compliance.The study showed that higher education and patients under 70 years old with highpositive factors had better medication compliance.Conclusion:Elder patients with hypertension in community have poor medication compliance. Subjective sense of well-being is at medium level.Subjective sense of well-being,especially positive factors is closely related to medication compliance.Enhancing subjective sense of well-being can improve medication compliance.
Objective:To explore the current status and correlation of medication compliance and subjective sense of well-being of elder patients with hypertension in community.Methods:333 elder patients with hypertension in community were surveyed with medication compliance scale proposed by MORISKY and MUNSH. Results:96 cases(28.8%)of the patients showed good compliance while 183 cases(55.0%) showed medium complianceand 54 cases(16.2%)showedpoor compliance.The subjective sense score of well-being was(32.67±6.02).Subjective sense of well-being and positive factors were positively correlated with medication compliance. Negative factors were negatively correlated with medication compliance.The study showed that higher education and patients under 70 years old with highpositive factors had better medication compliance.Conclusion:Elder patients with hypertension in community have poor medication compliance. Subjective sense of well-being is at medium level.Subjective sense of well-being,especially positive factors is closely related to medication compliance.Enhancing subjective sense of well-being can improve medication compliance.
引文
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[14] 童海宁,张竞超.社区高血压患者用药依从性及影响因素研究[J].中国药房,2015,26(11):1571-1573.
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[16] Gupta AK,Arshad S,Poulter NR.Compliance,safety and effectiveness of fixed-dose combinations of antihypertensive agents:a meta-analysis[J].Hypertension,2010,55(2):399-407.
[17] Checchi K.D,Huybrechts K.F,Avorn J,et al.Electronic medication packaging devices and medication adherence:a systematic review[J].The Journal of the American Medical Association,2014,312(12):1237–1247.
[18] Wai Yin Lam,Paula Fresco.Medication Adherence Measures:An Overview[J].BioMed Research International,2015,2015:217047.
[19] 李为华,李双力,程晓莉,等.重庆市老年高血压患者健康促进生活方式与主观幸福感的相关性研究[J].中国健康教育,2017,33(12):1094-1099.
[20] 张瑞芹,孙翠勇,张会敏,等.社区老年高血压患者主观幸福感、自我效能与积极心理健康状况[J].中国老年学杂志,2016,36(12):5978-5980.
[21] 何皖,杨艳,庞逸,等.老年高血压患者幸福感及其影响因素[J].中国老年学杂志,2014,34(6):3105-3106.
[22] 李月娥,卢珊.躯体健康、心理健康在老年人社会支持与主观幸福感间中介效应[J].中国公共卫生,2018,34(9):1274-1276.
[23] 赵彦超,赵士英,崔卫国.高血压患者现况及心理认知情况分析[J].中国公共卫生,2016,32(11):1573-1575.
[2] The Lancet.Ageing in China:a ticking bomb[J].Lancet,2016,388 (10056):2058.
[3] Lin H,Li Q,Hu Y,et al.The prevalence of multiple non- communicable diseases among middle-aged and elderly people:the Shanghai Changfeng Study[J].Eur J Epidemiol,2017,32(2):159-163.
[4] 国家卫生计生委合理用药专家委员会.高血压合理用药指南(第2版)[J].中国医学前沿杂志(电子版),2017,9(7):28-126.
[5] Diener E.Subjectwell-being[J].Psychol Bull,1984,95(3):542-575.
[6] 《中国高血压基层管理指南》修订委员会.中国高血压基层管理指南(2014年修订版) [J].中华健康管理学杂志,2015,9(1):10-30.
[7] 黄静.健康教育联合心理干预对老年高血压患者负性情绪及血压水平、生活质量的影响[J].中国老年学杂志,2018,32(13):3099-3112.
[8] Morisky DE,Green LW,Levine DM.Concurrent and predictive validity of a self-reported measure of medication adherence[J].Med Care,1986,24(1):67-74.
[9] 于黎,朱大乔.原发性高血压患者药物治疗依从性影响因素的分析[J].解放军护理杂志,2004,21(12):33-35.
[10] 胡海霞,刘丽婷,赵红,等.社区老年高血压患者自测健康状况与主观幸福感的相关性[J].中国老年学杂志,2014,34(1):164-168.
[11] Sabaté E.Adherence to Long-Term Therapies:Evidence for Action.Geneva,Switzerland:World Health Organization,2003[EB/OL].http://www.who.int/entity/chp/knowledge/publications/adherence_report/ en/index.html (0),2007-11-23.
[12] Brown M.T,Bussell J.K.Medication adherence:WHO cares?[J].Mayo Clinic Proceedings,2011,86(4):304-314.
[13] 陆瑛,赵加奎,林军,等.上海市黄浦区高血压患者用药依从性与自我效能的关系研究[J].中国健康教育,2017,33(3):228-231.
[14] 童海宁,张竞超.社区高血压患者用药依从性及影响因素研究[J].中国药房,2015,26(11):1571-1573.
[15] Vermeire E,Hearnshaw H,Van Royen P,et al.Patient adherence to treatment:three decades of research.A comprehensive review[J].Journal of Clinical Pharmacy and Therapeutics,2001,26(5):331-342.
[16] Gupta AK,Arshad S,Poulter NR.Compliance,safety and effectiveness of fixed-dose combinations of antihypertensive agents:a meta-analysis[J].Hypertension,2010,55(2):399-407.
[17] Checchi K.D,Huybrechts K.F,Avorn J,et al.Electronic medication packaging devices and medication adherence:a systematic review[J].The Journal of the American Medical Association,2014,312(12):1237–1247.
[18] Wai Yin Lam,Paula Fresco.Medication Adherence Measures:An Overview[J].BioMed Research International,2015,2015:217047.
[19] 李为华,李双力,程晓莉,等.重庆市老年高血压患者健康促进生活方式与主观幸福感的相关性研究[J].中国健康教育,2017,33(12):1094-1099.
[20] 张瑞芹,孙翠勇,张会敏,等.社区老年高血压患者主观幸福感、自我效能与积极心理健康状况[J].中国老年学杂志,2016,36(12):5978-5980.
[21] 何皖,杨艳,庞逸,等.老年高血压患者幸福感及其影响因素[J].中国老年学杂志,2014,34(6):3105-3106.
[22] 李月娥,卢珊.躯体健康、心理健康在老年人社会支持与主观幸福感间中介效应[J].中国公共卫生,2018,34(9):1274-1276.
[23] 赵彦超,赵士英,崔卫国.高血压患者现况及心理认知情况分析[J].中国公共卫生,2016,32(11):1573-1575.