糖尿病患者药物治疗依从性影响因素分析及护理干预

摘要

Objective To explore the influencing factors of medication therapeutic compli-ance and the related nursing interventions.Methods 200 patients with diabetes were divided into survey group (good adherence to drug therapy)and control group (poor adherence to drug treat-ment).The indexes such as the patient’s gender,age,education level,monthly income,duration of disease,understanding on drug therapy and medication type,the number of medication,adverse drug reactions,complications,diabetes cognition,payment of medical expenses,medical treatment and other aspects were investigated and analyzed in order to find out the reasons for poor therapeu-tic compliance and formulate the related intervention measures.Results Among 200 patients with diabetes,ratio of patients with good medication compliance was 35.5%(71 /200),and ratio of pa-tients with poor medication compliance was 64.5%(129 /200).Univariate analysis showed that 10 reasons were considered as the influencing factors of drug treatment compliance,including gender, age,education level,monthly income,type of medication,medication frequency,duration,com-plications,medical expenses,payment methods and doctor-patient relationship.There was a sig-nificant correlation between conscious discontinued medication,subjective health assessment,medi-cation forgotten for various reasons,medication and medical inconvenience abortion due to adverse drug reactions and therapeutic compliance(P <0.05).Conclusion Influencing factors of thera-peutic compliance are various,implementation of health education,good doctor-patient relation-ship and the establishment of individualized regimen,intervention formulation according to eco-nomic conditions and other aspects can improve compliance of patients.%目的：探索影响糖尿病患者药物治疗依从性的因素及护理干预措施。方法随机选取200例糖尿病患者，以药物治疗依从性好的研究对象作为调查组、药物治疗依从性差者作为对照组，从患者的性别、年龄、文化程度、月收入、病程、对疾病和药物治疗的了解、服药种类、服药次数、药物不良反应、并发症、糖尿病认知情况、医疗费用支付方式、求医条件等方面进行调查分析，分析患者药物治疗依从性差的原因，并针对这些原因制定干预措施。结果200例糖尿病调查对象中，药物治疗依从性好者占35．5％（71/200），药物治疗依从性差者占64．5％（129/200），单因素分析共筛查出10个影响药物治疗依从性的因素，为性别、年龄、文化程度、月收入、服药种类、服药次数、病程、并发症、医疗费用支付方式及医患关系。患者有意识终止用药、主观健康评估后、因各种原因忘记用药、因就医不便中止用药以及因药物不良反应中止用药对调查对象用药依从性有显著影响（P ＜0．05）。结论影响糖尿病患者药物治疗依从性的因素较多，应通过健康教育、建立良好的医患关系、建立个体化用药方案、根据经济情况制订方案等进行干预，从而改善患者依从性。