摘要
目的:调查内科慢性病共病住院患者多重用药现状及与护理风险事件的关系,并提出针对性的建议以帮助管理老年患者临床多重用药。方法:采用便利抽样的方法,于2020年3月—2021年1月选取四川省4家三甲综合医院内科住院的2254例老年住院患者开展问卷调查,分析患者一般情况、慢性病共病及多重用药等情况,并通过单因素及二元Logistic回归分析老年慢性病患者多重用药现状及对护理风险事件的影响。结果:不同年龄、体重、文化程度、个人月收入、医疗支付方式及是否衰弱、慢性病共病数量的患者是否多重用药差异有统计学意义(P<0.05),Logistic回归分析显示,患者文化程度和慢性病数量是其多重用药的独立危险因素(P<0.05)。是否多重用药的患者护理风险事件总数及压力性损伤、深静脉血栓及心脏骤停的发生差异有统计学意义(P<0.05)。在同样的共病状态下,多重用药患者的护理风险事件发生增加;而在同样多重用药的患者中,共病数量增加的患者护理风险事件的发生呈下降趋势。结论:对文化程度高、患慢病数量多、年龄在65~74岁的老年患者应格外注意是否有多重用药行为,未来需积极普及合理用药知识,积极预防慢性病发生,加强药物管理团队合作,多专科综合考虑治疗方案,进而从根本上减少多重用药。
Objective To investigate the current status of multi-drug use in elderly inpatients with multiple chronic conditions in internal medicine and its correlation with nursing risk events,and to put forward targeted suggestions to help manage clinical multiple drug use in elderly patients.Methods Using the convenient sampling method,a total of 2254 elderly inpatients in Department of Internal Medicine in 4 ClassⅢGrade A general hospitals in Sichuan province were selected to conduct a questionnaire survey from March 2020 to January 2021,and their general conditions,multiple chronic conditions and multiple drug use were analyzed.Single factor and binary Logistic regression were used to analyze the current situation of multiple drug use in elderly patients with chronic disease and its influence on nursing risk events.Results There were statistically significant differences in patients with different ages,weights,education levels,personal income,medical payment methods,whether they were weak or not,and whether patients with multiple chronic conditions took multiple drugs(P<0.05).Logistic regression analysis showed that education level and the number of chronic diseases were independent risk factors for multiple drug use(P<0.05).There were statistically significant differences in the total number of nursing risk events and the occurrence of pressure injuries,deep vein thrombosis and cardiac arrest in patients with multiple medications(P<0.05).In the same state of multimorbidity,the nursing risk events of patients with multiple drug use increased.In patients with the same multiple medications,the incidence of patient nursing risk events with an increase in the number of multimorbidities showed a downward trend.Conclusions Elderly patients with a high education level,a large number of chronic diseases and aged 65-74 years old should pay special attention to whether they have multiple drug use behaviors.In the future,it is necessary to actively popularize the knowledge of rational drug use,actively prevent the occurrence of
作者
叶子溦
袁丽
杨小玲
汪淼芹
杨雪
关碧
Ye Ziwei;Yuan Li;Yang Xiaoling;Wang Miaoqin;Yang Xue;Guan Bi(West China School of Nursing,Sichuan University/Department of Endocrinology and Metabolism,West China Hospital,Sichuan University,Chengdu 610044,China;Department of Endocrinology and Metabolism,West China Hospital,Sichuan University/West China School of Nursing,Sichuan University,Chengdu 610044,China;Department of Nursing,Affiliated Hospital of North Sichuan Medical College,Sichuan Province,Nanchong 637100,China;Department of Internal Medicine,People's Hospital of Leshan,Sichuan Province,Leshan 614800,China;Department of Nursing,Chengdu Fifth People's Hospital,Sichuan Province,Chengdu 611130,China)
出处
《中华现代护理杂志》
2021年第24期3312-3318,共7页
Chinese Journal of Modern Nursing
基金
四川大学华西护理学科发展专项基金项目(HXHL190005)
四川省卫生健康委科研项目(20PJ023)
四川省科技厅重点研发项目(2019YFS0305)。
关键词
慢性病
慢性病共病
多重用药
护理风险事件
Chronic disease
Multiple chronic conditions
Multiple drug use
Nursing adverse events
