哮喘患者感知控制力对糖皮质激素吸入治疗依从性的影响

摘要

目的 探讨哮喘患者感知控制力对吸入糖皮质激素治疗依从性的影响,为提高患者糖皮质激素治疗依从性提供参考.方法 采用方便抽样方法,选取哮喘患者,采用一般资料问卷、哮喘感知控制力问卷(PCAQ)、支气管哮喘用药依从性量表(MARS-A)进行调查.结果 118例患者的感知控制力总分为33.04±4.57;39.83％的患者吸入糖皮质激素治疗依从性好,60.17％的患者吸入糖皮质激素治疗依从性差;ICS治疗依从性与心理控制源、自我效能感呈正相关(r=0.678、0.653,均P＜0.01),与习得无助感呈负相关(r=-0.636,P＜0.01);文化程度、家族史、自我效能感、心理控制源和习得无助感是ICS治疗依从性的影响因素(均P＜0.01).结论 哮喘患者感知控制力水平低可影响糖皮质激素治疗依从性,提高哮喘患者感知控制力水平,恢复其对生活和疾病的控制,可以更好地提高哮喘患者ICS治疗的依从性.%Objective To explore the influence of perceived control on the inhaled corticosteroids treatment adherence among patients with asthma,and to offer reference for increasing patients' Inhaled Corticosteroids (ICS) treatment adherence.Methods Totally 118 patients with asthma were selected using convenience sampling,and they were investigated using the basic information questionnaire,Perceived Control of Asthma Questionnaire (PCAQ)and the Medication Adherence Report Scale(MARS-A).Results The mean score of PCAD for the 118 pateints was 33.04±4.57;the ICS treatment adherence for 39.83％ patients was good,the adherence for the other 60.17％ was poor.The ICS treatment adherence had positive correlations with health locus of control and selfefficacy (r=0.678,0.653,P＜0.01 for both),and had negative correlation with learned helplessness (r-0.636,P＜0.01).Logistic regression analysis showed that,educational background,the family history,self-efficacy,health locus of control and learned helplessness were determinants of ICS treatment adherence (P＜0.01 for all).Conclusion Low level of perceived control can influence the ICS treatment adherence among patients with asthma.Improving patients' perceived control,and restoring their control of life and disease,can improve their ICS treatment adherence better.