海帆,张宝琴,乔璟,张静芳,段大平,张起恒,郭玉洁,王莹,李本亮,杨世昌.郑州市严重精神障碍患者服药依从性的影响因素[J].四川精神卫生杂志,2022,35(6):531-536.Hai Fan,Zhang Baoqin,Qiao Jing,Zhang Jingfang,Duan Daping,Zhang Qiheng,Guo Yujie,Wang Ying,Li Benliang,Yang Shichang,Influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou[J].SICHUAN MENTAL HEALTH,2022,35(6):531-536

郑州市严重精神障碍患者服药依从性的影响因素

Influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou

投稿时间：2022-08-18

DOI：10.11886/scjsws20220818002

中文关键词: 严重精神障碍服药依从性影响因素

英文关键词:Severe mental disorders Medication adherence Influencing factors

基金项目:河南省2020年重大传染病防控精神卫生与慢性病防治专项（项目名称：精神卫生与慢性病防治项目，项目编号：豫财社［2019］190号）

作者	单位	邮编
海帆	郑州市第八人民医院新乡医学院第二附属医院	453002
张宝琴	郑州市疾病预防控制中心	450042
乔璟	郑州市第八人民医院新乡医学院第二附属医院	453002
张静芳	郑州市疾病预防控制中心	450042
段大平	郑州市疾病预防控制中心	450042
张起恒	郑州市疾病预防控制中心	450042
郭玉洁	郑州市第九人民医院	450053
王莹	郑州市疾病预防控制中心	450042
李本亮	郑州市疾病预防控制中心	450042
杨世昌^*	新乡医学院第二附属医院	453002

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中文摘要:

目的调查郑州市严重精神障碍患者服药依从情况并分析其影响因素，为制定严重精神障碍防治措施提供参考。方法于2021年3月-6月，采用分层多阶段整群抽样方法，从国家严重精神障碍信息系统中郑州市所有在册患者中选取342人为研究对象。采用自编问卷收集患者一般人口学资料，并调查其服药情况及影响因素，比较服药依从组与服药不依从组服药影响因素的差异，采用Logistic回归分析探讨服药依从性的影响因素。结果共320例患者纳入最终分析，其中服药依从者245人（76.56%）。服药依从组与服药不依从组在居住地、职业以及门诊慢性病报销办理情况方面差异均有统计学意义（χ²=14.015、7.502、13.106，P<0.05或0.01）。服药影响因素问卷评分方面，两组自知力缺失、病耻感以及药物相关因素因子评分差异均有统计学意义（Z=7.588、2.379、2.893，P<0.05或0.01）。已办理门诊慢性病报销是服药依从的保护因素（OR=2.727，95% CI：1.320~5.634，P<0.01），居住地为农村（OR=0.465，95% CI：0.221~0.977，P<0.05）和自知力缺失（OR=0.398，95% CI：0.286~0.553，P<0.01）是服药依从的危险因素。结论郑州市严重精神障碍患者服药依从比例较高，门诊慢性病报销办理、患者自知力缺失以及居住地可能是患者服药依从性的影响因素。

英文摘要:

Objective To investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders.Methods From March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence.Results A total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ²=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence.Conclusion Patients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.

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