慢性阻塞性肺部疾病病人藥物堅持性及其相關因素之探討

本研究目的旨在探討人口學特性、藥物特性、疾病嚴重度、健康知能與藥物堅持性之相關性以及藥物堅持性之影響因子。研究方法採橫斷、描述性相關性研究，以結構式問卷調查南部某區域醫院160位慢性阻塞性肺部疾病病人的人口學特性、藥物特性、健康知能及藥物堅持性行為。將所得資料以描述性統計、獨立樣本T檢定、單因子變異數分析(ANOVA)、皮爾森相關係數分析與多元性廻歸進行統計分析。研究結果顯示受試者藥物堅持整體性良好。在人口學特性之婚姻、主要照顧者與藥物副作用有顯著差異，顯示已婚、有照顧者、無藥物副作用的病人，藥物堅持性較好。年紀越大、疾病嚴重度越嚴重、健康知能的用藥資訊越好，藥物堅持性越好。年紀、疾病嚴重度及健康知能的用藥資訊為藥物堅持性的顯著影響因子，可解釋整體藥物堅持性的總變異數34%。研究結果可以讓護理人員瞭解慢性阻塞性肺部疾病人健康知能，加強病人用藥知識及增加記憶，對於陪同的家屬或是照顧者一同衛教，可以提昇病人藥物堅持性。

關鍵字

慢性阻塞性肺部疾病；藥物堅持性

並列摘要

Abstract The main purposes of this study were to explore the relationship between demographic variables, medication characteristics, severity of illness, health literacy, and medication adherence, and to explore the contributing factors of medication adherence. This was a cross-sectional, descriptive study using a survey method. A total of 160 chronic obstructive pulmonary disease patients were recruited from a regional hospital in Southern Taiwan. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation analysis and multiple regression analysis. The results showed that participants overall had good medication adherence. The medication adherence was significantly different among different marital status, caregivers and the frequency of medication side effects. Patients with spouses as the main caregiver and with no medication side effects had better medication adherence. The older, the higher level of COPD severity, the higher level of health literacy in medication information, the better the medication adherence. Age, severity of illness and medication information of health literacy were the significant contributing factors of medication adherence, and explained 34% of the variance of medication adherence. The study recommended that clinical nursing staff understood health literacy in COPD patients. They enhanced knowledge of medication and increased memories, and educated families or caregivers together, could improve patients medication adherence.