接受居家照護精神病患其遵囑服藥行為之調查性研究

A Survey Study of the Medication Adherence among the Psychiatric Patients Receiving Hospital-based Home Care Service

張雅芬(Ya-Fen Chang) ； 李世凱(Shih-Kai Lee) ； 邵文娟(Wen-Chuan Shao) ； 林靜蘭(Esther Ching-Lan Lin)

《精神衛生護理雜誌》 13卷1期 (2018/06) Pp. 26-34

https://doi.org/10.6847/TJPMHN.201806_13(1).04

摘要

背景：目前抗精神病藥物為精神疾病主要治療方式，然而，相較於一般疾病病患未遵囑治療比例約為20-50%，精神病患未遵囑治療比例高達50- 80%。目的：調查居家照護精神病患的遵囑服藥行為及其影響因素。方法：採調查性研究設計，立意選取中區某精神科教學醫院目前接受居家照護之社區精神病患共236人，調查其六個月期間實際服用抗精神病藥物次數及顆數的遵囑服藥行為。結果：以男性及曾住院之思覺失調症患者居多，平均年齡為51.78歲，平均發病年齡為27.20歲，實服抗精神病藥物次數與顆數之平均遵囑行為達87.3%及87.1%，遵囑服藥比例達80%以上之病患佔78%，病患曾否住院及不同居住區域其遵囑服藥行為有顯著差異。結論／實務應用：本研究以接受居家照護之精神病患為樣本，發現其多數具有良好遵囑服藥行為。未來宜比較有無接受居家照護病患於遵囑服藥行為之差異，以進一步支持居家照護的成效，或探討不同地理區域病患所接受居家照護之間的差異及其對遵囑服藥的影響為何。此初步研究結果可提供政府當局發展與規劃以居家照護增進精神病患遵囑服藥之社區照護政策的參考。

關鍵字

居家照護 ； 社區精神病患 ； 遵囑服藥行為

並列摘要

Background: Although antipsychotics have been regarded as the most effective therapy for mentally ill patients, the nonadherence rate of the mentally illness (50-80%) is higher than those of other illnesses (20-50%). Purpose: The purpose of this study was to investigate the medication adherence and related factors of the mentally ill patients receiving hospital-based home care service. Methods: Through using survey design, 236 patients who received hospital-based home care service were purposively recruited. Their medication adherence behaviors, including frequency of taking tablets, were surveyed with 6-month follow-up. Results: The majority was male, middle-aged, diagnosed as schizophrenia, adult onset of illness, and had hospitalized experience. The frequency and tablets-taking of antipsychotics adherence was 87.3 and 87.1% respectively. Seventy-eight percent of patients’ medication adherence have reached 80%. Significant differences of adherent behaviors were found in those who had previous hospitalization experience and lived in different areas. Conclusion/Implication for Practice: Most of psychiatric patients receiving home-care service in this study had adequate medication adherence. For future studies, we should further compare medication adherence of those who received psychiatric home care with those who received no home care treatment, and examine the difference of psychiatric home care among patients who live in different areas and their influences on medication adherence. Our preliminary results may inform healthcare and social welfare sectors of developing and implementing community care policy related to improving psychiatric patients’ medication adherence through home-care service.

並列關鍵字

home-care service ； psychiatric patients in community ； medication adherence behavior

參考文獻

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