摘要
目的 探讨影响妊娠期甲状腺功能减退患者合理用药行为的各项因素及其作用机制,为提升临床合理用药水平提供干预依据。方法 采用横断面研究问卷调查方式,应用单因素方差分析探索倾向因素、促成因素和加强因素的人口学特征,应用结构方程模型探索影响合理用药模型的拟合度和主要影响因子,采用多组结构方程探索不同教育水平下各潜变量的内部关联是否存在差异。结果 倾向因素得分(2.82±0.38)分、促成因素得分(2.31±0.54)分,加强因素得分(2.53±0.90)分。不同教育水平在倾向因素上存在显著差异。对合理用药行为影响倾向因素的总效应为1.59,促成因素的总效应为1.51,加强因素的总效应为0.52。不同教育水平PRECEDE模型形态基本一致,结构权重检验不一致(Δχ~2=386.71,Δd_(f)=23,P<0.01)。不同教育水平PRECEDE模型作用机制,路径系数均有统计学意义,但作用强度存在差异。结论 倾向因素对于妊娠期状腺功能减退患者用药行为影响最大,促成因素次之,加强因素影响效用最小,不同教育水平PRECEDE模型潜变量之间的路径系数存在差异。本研究使用结构方程模型对可能影响妊娠期甲状腺功能减退患者的主要因素进行了量化研究,为更有效地针对不同人群采取合理用药宣教方法提供了参考。
Objective To analyze the influence factors for rational drug use in patients with hypothyroidism during pregnancy and to provide evidence for targeted intervention in clinic.Methods Online questionnaire for cross-sectional study was conducted.One-way analysis of variance was used to determine the demographic characteristics of propensity factors,contributing factors and strengthening factors.Structural equation models were established to explore the fit and main influence factors of the rational drug use model,and multi-group structural equation models were used to explore the latent variables at different levels of education and the difference in internal associations.Results The propensity factor score was (2.82±0.38),the contributing factor score was (2.31±0.54),and the strengthening factor score was (2.53±0.90),with significant differences in tendencies among different education levels.The total effect of propensity factors on the rational drug use was 1.59,the total effect of contributing factors was 1.51,and the total effect of strengthening factors was 0.52.The shapes of PRECEDE models with different education levels were basically consistent,but the structural weight test was inconsistent (Δχ~2=386.71,Δd_(f)=23,P<0.01).The mechanism and path coefficient of the PRECEDE model of rational drug use with different education levels were significantly different,and the intensity of action was also different.Conclusion Propensity factors have the greatest impact on the medication behavior of patients with hypothyroidism during pregnant,followed by strengthening factors,while contributing factors have the least effect.The path coefficients of the latent variables of the PRECEDE model with different education levels are different.Structural equation modeling was used to quantify the main factors that may affect patients with hypothyroidism during pregnancy,which provide a reference for more effective and rational drug use education methods for various population.
作者
李轶凡
王安妮
冯欣
LI Yi-fan;WANG An-ni;FENG Xin(Beijing Obstetrics and Gynecology Hospital,Capital Medical University/Beijing Maternal and Child Health Care Hospital,Beijing 100026)
出处
《中南药学》
CAS
2022年第9期2179-2184,共6页
Central South Pharmacy
基金
中国药学会全国医药经济信息网科普研究重点项目[No.CMEI2021KPYJ(JZX)00303]。
