精神科门诊服药依从性及相关因素剖析.docVIP

精神科门诊服药依从性及相关因素剖析 　　[摘要] 目的 探讨在自然非干预状态下影响精神科门诊患者服药依从性和相关因素。 方法 选择2013年11月～2014年11月首都医科大学附属北京安定医院精神科普通门诊患者309例，采用服药依从性量表进行调查，并分析影响药物依从性的相关因素。 结果 精神科门诊40.5%的患者依从性差，其中精神分裂症、抑郁症和双相情感障碍中不依从比例分别为35.6%、44.6%和29.3%。精神科门诊患者依从性不好主要是由于忘记服药，27.4%精神分裂症患者主要因为大意而忘记服药；而其他两种疾病患者在身体状况比较好时忘记服药，比例分别为44.1%和43.9%。门诊患者对药物治疗作用和维持治疗持否定态度的比例分别为54.4%和69.6%。依从和不依从的患者在工作状态、独立程度和目前病情方面比较，差异有统计学意义（χ2=19.480、10.392、14.567，P 0.05 或P 0.01）。年龄、独立程度与服药依从性量表总分呈正相关（r = 0.143、0.148，P 0.05 或P 0.01）。 结论 精神科门诊患者服药依从性并不乐观，不同疾病影响依从性的因素不同，相关因素包括患者的年龄、工作状态、独立程度和目前病情。 　　[关键词] 精神障碍；门诊治疗；服药依从性量表；依从性 　　[中图分类号] R74 [文献标识码] A [文章编号] 1673-7210（2015）08（b）-0165-05 　　[Abstract] Objective To explore the compliance and related factors of the psychiatric outpatients in natural state. Method From November 2013 to November 2014， in Beijing Anding Hospital， Capital Medical University， 309 psychiatric outpatients were investigated using medication adherence rating scale （MARS） in order to analyze the related factors influencing medication adherence. Results The compliance of the psychiatric of 40.5% outpatients was poor， the rate of no-adherence in schizophrenia， depression and bipolar disorder were 35.6%， 44.6% and 29.3% respectively. The main reason of poor compliance in the psychiatric outpatients was forgetting to take medicine. 27.4% schizophrenic patients forgot to take medicine mainly because of carelessness； the rate of depression and bipolar disorder patients who forgot to take medicine when they were well were 44.1% and 43.9% respectively. 54.4% patients took a negative attitude towards medication effects and 69.6% patients took a negative attitude towards maintenance. There was no significant difference on working status， degree of independence and the current condition of disease between patients with and without adherence （χ2 = 19.480， 10.392， 14.567， P 0.05 or P 0.01）. Age and degree of independence were positive correlated with total MARS scores （r = 0.143， 0.148， P 0.05 or P 0.01）. Conclusion The co