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  • 學位論文

影響老人自服西藥及中草藥因素之探討

Factors affecting Self-Medication among Elderly in Taiwan

指導教授 : 戴 玉慈

摘要


老人自服藥物行為是護理照護常見的問題,由於老化所產生的生理變化,通常會伴隨慢性病發生,面對慢性病所帶來的身體不適,除了尋求醫師處方藥外,可能會自服非處方藥來治療疾病或改善症狀,然而老人很少會跟醫師討論有關自服成藥或中草藥的情形,可能會發生藥物間交互作用的危險,礙於門診看診時間短暫,醫護人員常未能詳細評估老人自服非處方藥的情形,因此,本研究目的為探討人口學變項、憂鬱狀態、健康狀態、醫療利用次數、社會互動與媒體廣告因素與老人自服西藥或中草藥之間的關係,並調查老人使用西藥或中草藥之現況。 本研究為橫斷性研究,採立意取樣,在台北市某老人活動中心及醫學中心門診,收65歲(含)以上符合收案條件的老人進行訪談共250位,將本研究重要發現歸納如下: 1.本研究共收250位老人,自服西藥者有147位(58.8%),自服中草藥者有82位(32.8%),其中同時自服西藥和中草藥者有49位(19.6%),未自服西藥和中草藥者有70位(28.0%)。 2.在自服西藥方面,有78.2%的老人會固定看西醫,有6.1%老人固定看中醫,多數老人自述規律服用處方藥,其自服藥物目的為保健或治療,多數藥品是自己或子女所購買,以去國外買西藥最多。 3.在自服中草藥方面,有74.4%老人會固定看西醫,有4.9%老人會固定看中醫,其自服藥物理由以保健(60.9%)多於治療目的(20.7%),藥物來源以自己(67%)多於子女購買(20.7%),買中草藥地點以去中藥房購買最多。 4. 老人自服西藥迴歸模式結果為女性自服西藥的機率是男性的2.41倍(95% CI=1.37-4.20);65-74歲的老人,自服西藥是75歲以上老人的2.37倍(95% CI=1.36-4.12);看西醫1次以上者,自服西藥是看西醫0-1次者的2.30倍(95% CI=1.23-4.30);有接受社會互動與媒體廣告訊息者,自服西藥是沒有受社會互動與媒體廣告訊息者的1.83倍(95% CI=1.05-3.19)。 5.老人自服中草藥迴歸模式結果為每月可支配15000元以上者,其自服中草藥是每月可支配15000元以下者的1.68倍(95% CI=0.97-2.89),其他的人口學變項、憂鬱狀態、健康狀態、醫療利用次數和社會互動與媒體廣告,皆未能預測中草藥服用。 透過本研究結果,可幫助護理人員對評估老人自服藥物行為,有更深入的瞭解,能協助及早發現自服藥物的高危險群,給予妥善預防及適當處置,發揮護理獨特功能,以增進老人的生活品質。

並列摘要


Senior citizens taking non-prescription medicine is a common problem in nursing care. Physiological changes that accompany aging usually associated with chronic diseases. Apart from taking prescription medicine dispensed by physicians, senior citizens faced with ailments or disorders are also likely to resort to nonprescription medicine to treat illnesses or alleviate symptoms. Nonetheless, these senior citizens seldom discuss with physicians whether or how they take non-prescription medicines or Chinese herbs, and this may lead to the danger of drug interactions. Due to the time limit during clinic visits, medical staff is often unable to assess in detail the effects experienced by senior citizens that take non-prescription medicines. For the above reason, this study aims to find out the correlations between senior citizens taking non-prescription western medicines and Chinese herbs and factors such as demographic variants, depression , state of health, medical service utilization, social interaction, and media commercials, so as to investigate the current situation of senior citizens using western medicines and Chinese herbs. This cross-sectional study adopted a purposive sampling method. After interviewing a total of 250 elders 65 persons old or above who met the sampling criteria at both a senior activity center and outpatient department of a medical center in Taipei City, this study obtained the following findings: 1. Among the 250 senior citizens in this study, 147 took nonprescription western medicines (58.8%), 82 took nonprescription Chinese herbs (32.8%), and 49 took both nonprescription western medicines and Chinese herbs at the same time (19.6%). 2. Among the senior citizens that took non-prescription western medicine, 78.2% of them visited western physicians on a regular basis, while 6.1% visited Chinese medicine physicians on a regular basis. Most of these senior citizens stated that they followed the instructions for taking non-prescription medicine, and that the reasons of taking medicine were to stay healthy and treat illnesses. Most of the medicines they took were purchased either by themselves or by their children, and were purchased abroad. 3. Among the senior citizens that took non-prescription Chinese herbs, 74.4% of them visited western physicians on a regular basis, while 4.9% visited Chinese medicine physicians on a regular basis. The main purpose of taking nonprescription medicine was to stay healthy (60.9%), higher than the purpose of illness treatment (20.7%). The main source of medicine is self-purchase (67%), a higher percentage than that purchased by the senior citizens’ children (20.7%). In addition, most of the Chinese herbs the senior citizens purchased were from Chinese medicine pharmacies. 4. The results of the regression model of senior citizens that took non-prescription western medicines were as follows. Women were more likely to take nonprescription medicines than men, with a probability 2.41 times of the latter (95% CI=1.37-4.20). Senior citizens between 65-74 years old were more likely to take nonprescription western medicines than senior citizens more than 75 years old, with a probability 2.37 times higher than the latter (95% CI=1.36-4.12). Senior citizens who visited western physicians at least once were more likely to take nonprescription than senior citizens who visited physicians on only 0-1 occasion, with a probability 2.3 times higher than the latter (95% CI=1.23-4.30). Senior citizens who participated in social interaction and receive media commercial information were more likely to take nonprescription medicine than those who did not, and the probability was 1.83 times higher (95% CI=1.05-3.19). 5. The result of the regression model of senior citizens who took nonprescription Chinese herbs were as follows. Senior citizens with a monthly income of NT$15,000 or above at their disposable took 1.68 times more Chinese herbs than those with a monthly disposable income of less than NT$15,000 (95% CI=0.97-2.9). Other factors, including demographic variants, depression, health state, medical service utilization, social interaction, and media commercials all failed to predict the taking of Chinese herbs. Results revealed in this study help nursing staff evaluate and further understand senior citizens’ behavior in regards to taking non-prescription medicine, and thereby assists them to discover high risk groups for taking non-prescription medicine at the earliest time possible, and provides them with detailed assessments and timely suggestions to fully achieve the specific goals of nursing care and to improve senior citizens’ quality of life.

參考文獻


郝宏恕 翁瑞宏(2004)•全民健康保險中醫門診利用暨影響因素之研究•醫院,37(1),27-42。
黃璉華(1996)•社區老人用藥團體教育之成效•中華衛誌,15(3),197-207。
行政院衛生署(2003) •衛生統計(一)•台北:行政院衛生署。
余祥霖(2001)•中草藥產業現況與趨勢•台北:財團法人生物科技開發中心。
黃盈翔、盧豐華(2003)•老人之用藥原則•台灣醫學,7(3),385-395。

被引用紀錄


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黃雅婷(2012)。痛風病患服藥經驗之探討〔碩士論文,中臺科技大學〕。華藝線上圖書館。https://doi.org/10.6822%2fCTUST.2012.00081
楊玨璿(2009)。某醫學中心門診高血壓病人服藥遵守行為之探討--自我效能及行動線索之影響〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2009.02253
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張家蓉(2011)。台灣地區中老年人保健食品使用相關因素探討〔碩士論文,亞洲大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0118-1511201215470866

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