應用健康信念模式探討高血壓病人服藥遵從性

Applying a Health Belief Model to Explore Adherence Among Patients With Hypertension

黃玉惠(Yu-Hui Huang) ； 黃玉君(Yu-Chun Huang) ； 林麗鳳(Li-Feng Lin)

《榮總護理》 35卷3期 (2018/09) Pp. 289-301

https://doi.org/10.6142/VGHN.201809_35(3).0008

摘要

本研究旨在應用健康信念模式探討社區高血壓病人服藥遵從性。採橫斷性調查研究法，以方便取樣自嘉義市某區域教學醫院社區關懷據點394位符合收案標準的高血壓病人，以結構式問卷收集資料，內容包括基本屬性量表、高血壓服藥遵從信念量表、服藥遵從行為之行動線索量表、高血壓服藥遵從行為量表，研究期間2016年7月15日至2017年1月19日。結果顯示受試者平均年齡72.5±9.7歲，66%為女性。高血壓病人服藥遵從性與高血壓罹病年數、收縮壓、自覺罹患高血壓之風險性、自覺採取服藥遵從行為的利益性及行動線索呈正相關，與自覺採取服藥遵從行為的障礙性呈負相關，顯示採取服藥遵從行為的障礙越少，則服藥遵從行為越高，服藥遵從行為越好者，血壓控制越好（p＜ .05）。以逐步迴歸分析探討影響高血壓病人服藥遵從性之預測因子，結果顯示服藥遵從行為之行動線索、自覺服藥遵從行為的障礙性、高血壓罹病年數、收縮壓數值以及服用藥物次數的總解釋量達29%，本研究結果可供醫護人員在社區倡導高血壓病人服藥遵從性的參考。

關鍵字

高血壓病人 ； 服藥遵從性 ； 健康信念模式

並列摘要

The aim of this study was to apply the health belief model to explore medication adherence in patients with hypertension in the community. A cross-sectional investigation method was adopted to facilitate the sampling of 394 patients with hypertension who met the acceptance criteria from the community care base of a regional teaching hospital in Chiayi City. Data were collected using structured questionnaires including the Essential Attribute Scale, the Hypertension Medication Adherence Belief Scale, the Action Criteria Scale for Medication Adherence, and the Hypertension Medication Adherence Behavior Scale. The research period lasted from July 15, 2016, to January 19, 2017. The results revealed that the mean age of the participants was 72.5 ± 9.7 years and that 66% were women. Patients with hypertension were positively correlated with the number of years of hypertension, systolic blood pressure, perceived hypertension susceptibility, and perceived benefits of action and action cues. A negative correlation was identified with the perceived barriers of action, indicating that the fewer the barriers to medication adherence behavior were, the higher the medication adherence behavior was. Medication adherence behavior was negatively correlated with blood pressure control (p ＜ .05). A univariate analysis showed that determinant factors of medication adherence included perceived susceptibility, benefits, barriers, and cues to action. Multiple regression analysis revealed that cues to action, perceived barriers of action, hypertension, systolic blood pressure, and medication taking frequency accounted for 29% of medication adherence. Furthermore, cues to action constituted the major predictor (20.7%). The results of this study can provide further information regarding medication adherence for medical staff working in the community.

並列關鍵字

hypertensive patients ； medication adherence ； health belief model

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