摘要
目的探讨基于人因学的老年患者家庭正确用药情况。方法选取2013年1月—2014年11月在温州医科大学附属第一医院住院后出院的老年高血压患者240例,根据患者文化程度分为不识字(60例)、小学(60例)、初/高中(60例)、高中以上(60例)4个层次,按出院顺序每个层内连续编号,单号分为对照组,双号为试验组。其中对照组患者采用以文字表述的传统医嘱,试验组患者采用以图案代表用药时间、给药途径和用药剂量的图示医嘱。经护士宣教后4 h,比较两组患者医嘱正确识别率;出院随访2个月,比较两组患者家庭用药依从性。结果试验组患者医嘱正确识别率高于对照组,差异有统计学意义(χ2=56.88,P<0.01)。不同文化程度的试验组患者医嘱正确识别率间差异无统计学意义(χ2=5.67,P=0.12);而不同文化程度的对照组患者医嘱正确识别率间差异有统计学意义(χ2=67.96,P<0.01)。两组患者在服药方法正确、剂量正确、服药时间正确、不擅自停药依从性评分的分布上差异均有统计学意义(χ2值分别为33.91、26.04、63.90、60.22,P<0.01)。结论基于人因学的看图对话工具能够提高老年患者的用药正确率和家庭用药依从性。
Objective To explore the status of domestic correct drug administration of elderly patients based on ergonomics. Methods We enrolled 240 elderly patients with hypertension who discharged from the First Affiliated Hospital of Wenzhou Medical University from January 2013 to November 2014. According to educational levels,the subjects were divided into four levels：illiteracy（n = 60）,primary school（n = 60）,junior/ senior high school（ n = 60）and being above senior high school（n = 60）. Serial numbers were assigned in each level according to the sequence of discharge. Subjects with odd numbers were assigned into control group,and subjects with even number were assigned into trial group. In control group,the instruction of drug administration was given by words;in trial group,the instruction of drug administration was given by graphic patterns which indicated time,approach and dosage. After 4 h education by nurses,the rate of correct recognition of doctors＇ instruction was compared between the two groups;during the 2 - month follow - up after discharge,medication compliance was compared between the two groups. Results Trial group was higher than control group in the rate of correct recognition of doctors＇ instruction （χ2 = 56. 88,P 〈 0. 01）. In trial group,the rate of correct recognition of doctors＇ instruction did not vary significantly with educational level（ χ2 = 5. 67,P = 0. 12）;in control group,the rate of correct recognition of doctors＇ instruction varied＆amp;nbsp;significantly with educational level（χ2 = 67. 96,P 〈 0. 01）. The two groups were significantly different in the score distribution of the correct method of drug administration,correct dosage,correct medication time and no arbitrary halt of drug administration （χ2 was 33. 91,26. 04,63. 90 and 60. 22 respectively,P 〈 0. 01）. Conclusion Picture dialogue tools based on ergonomics can improve the rate of correct drug administration and domestic medication compliance.
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第25期3114-3116,3120,共4页
Chinese General Practice
基金
2014年浙江省医药卫生科技计划项目(2014KYA135)
