門診肺結核病人服藥遵從性及其相關因素之探討－－以某區域醫院為例

THE EXPLORATION OF DRUG COMPLIANCE AND RELATED FACTORS IN TUBERCULOSIS OUTPATIENTS:AN EXAMPLE FROM A REGIONAL HOSPITAL

結核病是我國也是全世界最嚴重的傳染病，由於治療期長及藥物副作用等因素造成病患不規則服藥，常是引發後續轉為抗藥性結核病的原因。本研究目的旨在探討肺結核病患之於肺結核的知識、態度與服藥遵從性的情形及其相關因素。研究採橫斷式問卷調查法，以立意取樣方式，針對中部某區域醫院胸腔科門診看診肺結核服藥一個月病患為研究對象，進行結構式問卷調查。問卷內容包括人口學變項、肺結核知識量表、肺結核態度量表、服藥遵從性量表四部分，三個量表的信度分別為 K-R 20 值0.75、Cronbach’s α 值為0.82 和0.71，共回收有效問卷82 份（94.2%），以SPSS12.0 統計軟體進行分析與檢定。研究結果發現：肺結核知識平均得分18.73（滿分24 分），肺結核態度平均得分54.39（滿分65 分），服藥遵從性平均得分31.21（滿分35 分）。肺結核病患之婚姻狀況、居住狀況在肺結核態度有顯著差異（p＜.05）；肺結核病患之年齡、性別、教育程度、婚姻狀況、居住狀況等在服藥遵從性方面無顯著性差異；肺結核病患副作用次數與服藥遵從性呈負相關。本研究建議臨床護理人員應主動瞭解患者因副作用造成生理不適外，同時在心理層面，多傾聽患者想法及感受，以提高服藥遵從性。

Tuberculosis is the most serious infectious disease in Taiwan and around the world. Factors such as long treatment time and side effects of drugs result in irregular medication, and eventually in drug-resistant tuberculosis. The purpose of this study is to explore tuberculosis patients’knowledge, attitude, and medication compliance. A cross-sectional questionnaire survey was adopted through purposive sampling. The subjects were patients of the outpatient clinic of the Chest Department in a regional hospital who had been on medication for tuberculosis for one month. The subjects completed a structural questionnaire survey. The contents of the questionnaire survey consist of four parts:demographic variables, tuberculosis knowledge scales, tuberculosis attitude scales and medication compliance scales. The three scales have a K-R20 value of 0.75, and the Cronbach’s α values are 0.82 and 0.71. A total of 82 valid questionnaires (94.2%) were recovered. Through the spss12.0 statistical software, the analysis and test were conducted. The research results show a mean score of 18.73 for knowledge of tuberculosis, a mean score of 54.39 for attitude toward tuberculosis, and a mean score of 31.21 for medication compliance. The tuberculosis patients’ marital status, living conditions, and attitude toward tuberculosis reached the level of significant difference p < .05). The tuberculosis patients’age, gender, education level, marital status, living condition, etc., did not affect medication compliance. The tuberculosis patients’frequency of side effects showed a negative correlation with medication compliance. This study recommends that clinical nursing staff take the initiative to find out more about patients’discomfort due to the side effects experienced and cater to patients’psychological needs by listening to their thoughts and feelings in order to improve medication compliance.