高血壓病人服藥遵從性及血壓控制之相關分析

高血壓是常見的慢性病，與心臟疾病、腦血管疾病等息息相關，高血壓病人若未遵醫囑按時按量服藥，血壓便無法有效的控制，進而加重疾病嚴重度與併發症。本研究藉由健康信念模概念，探討社區高血壓民眾在服藥遵從行為的狀況與血壓控制的相關分析。研究採橫斷性調查研究法（cross-sectional study）進行研究，以方便取樣符合研究目的之高血壓病人，自填結構式問卷的方式，進行資料收集調查，所得資料以SPSS18.0統計套裝軟體進行分析。研究對象年齡分布40-98歲，平均年齡72.46±9.68歲，66%為女性。在自身服藥遵從行為，總分為80.06±13.63分，顯示受訪對象約八成遵從行為是好的。影響高血壓病人服藥遵從性的相關因素為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障礙性、行動線索。服藥遵從行為越好者，血壓控制越好 (p<0.05)。預測高血壓病人服藥遵從性的重要因子為：行動線索、自覺服藥遵從行為的障礙性、自己高血壓疾病、收縮壓、與配偶子女同住、服用藥物次數，總解釋量達29%，而行動線索是相對主要的因子，解釋力達20.7%。上述結果可以提供醫護人員在社區倡導服藥遵從性的工作參考。

關鍵字

高血壓病人；服藥遵從性；血壓控制；健康信念模式

並列摘要

Hypertension is a common disease associated with cardiovascular disease and neurological vascular disorders. Blood pressure couldn’t be controlled well if the patient got poor medication adherence, which might increase disease severity and lead to some complications.This study is based on Health Belief Model to explore the association between medication adherence and blood pressure among people in the community. A battery of questionnaires was used in this cross-sectional study and the data was analyzed by SPSS18.0. The age of participants was between 40-98 and the average age was 72.46±9.68. Most of them were female (66%). The average score of medication adherence was 80.06±13.63,indicating most participants(80%) had good medication adherence. The influencing factors of medication adherence among patients with hypertension were perceived susceptiblity、perceived benefits of action、perceived barriers of action、cues to action. Behavior of medication adherence was negatively,the better of blood pressure control (p <0.05). The predictors of medication adherence among patients with hypertension patients were cues to action、perceived barriers of action、hypertension, diastolic blood pressure, living with spouses and children and the frenqucies of medication taking, which accounted for medication adherence 29%. cues to action was the primary predictor and accounted for medication adherence 20.7%. The results of this study can provide further information of medication adherence to medical staffs, working in community.