Title

社區老人罹患高血壓服藥遵從性之相關因素探討

Translated Titles

To explore the related factors of medication adherence in community-dwelling older adults with hypertension

Authors

吳玫容

Key Words

高血壓 ; 服藥遵從性 ; 老年人 ; Hypertension ; medication adherence ; the aged

PublicationName

長榮大學護理學系(所)學位論文

Volume or Term/Year and Month of Publication

2017年

Academic Degree Category

碩士

Advisor

黃芷苓

Content Language

繁體中文

Chinese Abstract

背景:高血壓 是2015年台灣地區 十大死因第八位,而且高血壓控制不佳是心臟疾病及腦血管疾病之高危險因子,目前較無文獻探討此族群其高血壓服藥遵從性之相關因素。 目的:探討台灣地區老年高血壓患者之服藥遵從性的相關因素。 方法:本研究為橫斷性相關性研究設計,於南部某鄉鎮,於社區關懷照顧據點或社區發展協會以口頭同意書招募符合資格之對象,符合條件為:(1)65歲(含)以上;(2)確診為高血壓;(3)過去一年曾經就醫且目前有服用高血壓藥物;(4)可以以國台語溝通者;排除條件為:(1)末期病人(如腎臟衰竭、心臟衰竭); (2)精神疾病(如精神分裂症、憂鬱症);(3)無法用國台語溝通者。以一對一訪談方式收集資料,共獲得有效樣本215位。研究工具為結構式問卷,包含服藥遵從性、疾病易感性、醫療健康概念、社會支持及社會人口學因素。統計方法為描述性統計、t檢定、卡方檢定、Pearson’s correlation。 結果:本研究結果發現社區老人服藥遵從性與飲食習慣有關,喜愛食用醃製燒烤類者與服藥遵從性呈正向關係;另受訪個案之個體特質亦影響其服藥遵從性,本研究結果發現喜愛食用醃製燒烤類病人的服藥遵從性較低(χ²=8.14, p<.01),但特殊疾病易感性較高(t=3.74, p<.01)、一般疾病易感性較高(t=3.46, p<.01)、自覺引起高血壓的原因較高(t=4.21, p<.01)、健康相關的社會支持高者(t=3.47, p<.01),其服藥遵從性反而是較低。 結論:罹患高血壓的老年人,並不會因為高血壓相關疾病之易感性、高血壓成因及醫療照護之認知,以及社會支持的改變等而影響其服藥遵從行為,此結果與研究假設不同,最有可能的原因是因為社會期望所造成的,因此受訪者未能真實呈現服藥遵從的情形。未來研究應該在社區活動中心進行收案以減少社會期望對於研究結果影響。

English Abstract

Background: Hypertension ranks 8th among the top 10 causes of death in Taiwan, 2015. Also poor control of blood pressure is a high risk factor that may lead to heart disease and cerebrovascular disease. Currently there has been few papers discussing the related factors of medication adherence. Purpose: The aim of the study was to explore the factors associated with medication adherence of the community elderly with the hypertensive disorders in Taiwan. Method: The study was designed as a cross-sectional and correlational study conducted. In the southern Taiwan, The inclusive criterion was : (1) be aged 65 or over, (2) diagnosed with the hypertensive disorders, (3) has visited medical clinics and is currently taking drugs, (4)can communicate in Chinese or Taiwanese. The exclusion criteria was be: (1)be terminally ill (e.g. kidney failure or heart failure), (2) be mentally ill (e.g., schizophrenia or depression), (3) cannot communicate in Chinese or Taiwanese. The data was collected by one-to -one interview. A total of 215 participants were recruited. The structured questionnaire included medication adherence, perceived susceptibility to specific diseases, perceived susceptibility in general, beliefs about causes of hypertension, health perceptions of western medications, health perceptions of Chinese herbs, beneficial self-care behaviors, health-related social support and social support in general. The statistical method included descriptive statistics, the t-test, the Chi-square test and Pearson’s correlation using SPSS 20.0 statistic software. Results: The results of this study showed that diet habits about favor edible pickled barbecue was associated with medication adherence (χ²=8.14, p< .01). The adherence was respectively associated with perceived susceptibility of specific diseases (t=3.74, p< .01), perceived susceptibility in general (t=3.46, p< .01), beneficial self-care behaviors (t=4.21, p< .01), and health-related social support (t=3.47, p< .01). Conclusion: The results did not meet our research hypothesis. Social expectations may result in participants’ estimation regarding their hypertension disease susceptibility, hypertension causes and Health Perceptions, knowledge, and changes in Health-Related Social Support. Future research will be conducted in community centers to reduce the influence of social expectations.

Topic Category 醫藥衛生 > 社會醫學
健康科學學院 > 護理學系(所)
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