老年高血壓患者服藥遵從行為及其影響因素之研究

An Exploration of the Drug Compliant Behaviors and Influenced Factors of Elderly Hypertensive Patients

胡文郁(Wen-Yu Hu) ； 戴玉慈(Yu-Tzu Tai) ； 于博芮(Po-Jui Yu) ； 余玉眉(Yu-Mei Yu Chao) ； 曾春典(Chuen-Den Tseng)

《慈濟醫學雜誌》 11卷3期 (1999/09) Pp. 227-235

https://doi.org/10.6440/TZUCMJ.199909.0227

摘要

目的：探討罹患高血壓之老年患者服藥遵從行為、遵從率及其影響因素。病人及方法：採二階段分層不等比率系統隨機抽樣，自台灣區十七個醫療區域中選取桃園及台中醫療網之醫院、衛生所建檔之300位65歲以上罹患原發性高血壓患者，進行居家訪視會談及自陳式結構性問卷量表調查。結果：老年高血壓患者最常發生減少服藥次數、更改服藥時間、停止或斷續服藥的行為。服藥遵從行為量表平均得分小於等於3.8分，即每星期有2天以上未服藥者，其收縮壓值或舒張壓值會高於正常範圍(依世界衛生組織定義)，據此標準，求得國人罹患高血壓之老年患者，其服藥不遵從率為17.97%，遵從率為44.41%。因徑分析結果發現，教育程度、語言需透過抗高血壓藥物知識，對服藥遵從行為產生間接之影響；年齡則需透過醫病關係影響健康信念，間接對服藥遵從行為產生影響。結論：服用抗高血壓藥物的顆數(三、四顆)、抗高血壓藥物的認知及親友支持，對老年患者的服藥遵從行為有正向且直接之影響；抗高血壓藥物壞處的感受，則為負向且直接之影響，其解釋力(R2)為19.88%。

關鍵字

老年人 ； 服藥遵從行為 ； 健康信念 ； 內外控人格特質 ； 高血壓知識

並列摘要

Objective: To investigate drug compliant behaviors, compliant rate and predicting factors of the compliant behaviors of elderly hypertensive patients in Taiwan using a cross-sectional, correlational design with causal modeling approach. Patients and Methods: The sampling procedure consisted of two phases of stratified, systemic random sampling. Tree hundred hypertensive patients who had been treated for over three months were recruited from hospitals and public health clinics which belong to the Taoyuan and Taichung health care network in North and Central Taiwan, R.O.C.. Data were collected by interviewing the patients with a structured questionnaire while recording their blood pressure. Results: The major findings of the study were: (1) An objective definition of drug noncompliant behavior was obtained with a score on compliant behavior scale of less than 3.8, where systolic blood pressure was more than 160 mmHg or where diastolic blood pressure was more than 95 mmHg. According to this definition, the drug noncompliant rate was 17.97%, and compliant rate was 44.41%. (2) The type of dialect used and educational level affected drug compliant behavior indirectly via the mediating effect of patient’s knowledge on hypertension. (3) The patients’ age and doctor-patient relationship affected drug compliant behavior via the mediating effect of health beliefs. Conclusions: Four significant predicting variables in the model were knowledge of antihypertensive drug, pill counts, family support and perception of antihypertensive drug’s disadvantage. They explained 19.88% of the total variance of drug compliant behavior.

並列關鍵字

hypertension ； drug compliant behavior ； health belief ； elderly ； hypertensive knowledge