慢性病人服藥配合度行為相關因素之問卷調查研究

目的：服藥配合度不佳可能導致疾病無法得到有效治療，還可能衍生出其他藥物不良反應，因此了解病人服藥配合度之相關因素，以利提出有效對策，增進醫病溝通及提升病患服藥配合度。方法：以計畫行為理論與健康信念模式為基礎建構問卷之構面，透過問卷結果了解影響病人服藥之因素。以台北市某區域教學醫院為主要收案場所，將問卷數據進行項目分析、信度檢測一致性與確立問卷信效度後，使用SPSS進行Pearson's相關性分析、以及多元階層迴歸分析探索各理論中，其構面對服藥配合度的相關因素與解釋力。結果：本研究共收集307份有效問卷樣本。分析計畫行為理論中各構面與人口學變項之關聯性後，具統計上顯著之相關構面為態度與行為意念，解釋力為24.1%。健康信念模式模型中，具統計上顯著之相關構面為自覺行動障礙與自我效能，解釋力28.4%。結論：計畫行為理論與健康信念模式皆可用來研究服藥配合度行為，且健康信念模式相較於計畫行為理論去預測慢性病人服藥配合度有較好的解釋力。Purpose: As medication non-adherence may exacerbate disease progression and result in drug-related problems, it is of great importance to examine the factors affecting patient's medication adherence to develop effective solutions that help improve the communication between physicians and patients. Methods: A questionnaire was designed based on two theories of behavior change: the theory of planned behavior (TPB) and the health belief model (HBM). The validated questionnaire was administered to patients of a regional hospital in Taipei. Item analysis included missing rate, comparisons of extreme groups, correlation between item and total score, Cronbach's α after item deletion, and Cronbach's α reliability test. Pearson's correlation, multiple hierarchical regression analysis and the power of TPB and HBM models were conducted for further statistical analysis. Results: A total of 307 valid questionnaires were analyzed. The TPB model indicated that attitude and behavioral intention exerted significant effects on medication adherence. Adjusted R^2 was 24.1%. As to the HBM model, perceived barrier and self-efficacy were significant factors. Adjusted R^2 was 28.4%. Conclusion: The study identified several behavioral factors or barriers which might potentially affect medication adherence. Both TPB and HBM can be used to study medication adherence with the latter reporting a greater power in predicting medication adherence of chronic patients.