移植病患之免疫抑制劑服藥遵從性

Factors Associated with Adherence to Immunosuppressive Therapy among Transplant Recipients

隨著醫療科技的進步，器官移植已成為治療器官衰竭的新興手術。然而病患在接受移植手術後，必須終生服用免疫抑制劑，以維持良好的移植器官功能。免疫抑制劑的不遵從除了會影響移植器官功能，相對可能降低生活品質，甚至危及生命導致死亡，並增加醫療負擔及社會成本。世界衛生組織（World Health Organization, WHO）於2003年所發表的遵從性模式歸納出五個影響因素，分別是社會經濟（social and economic）、健康照護系統（health care team and system）、情境（condition）、患者（patient）、治療（therapy）等因素。臨床醫護人員若能即早瞭解影響免疫抑制劑遵從性之相關因素，將可預防不遵從所造成的身心傷害。本文以WHO的遵從性模式為例，探討移植病患對免疫抑制劑服藥遵從性之相關因素，做為臨床護理與衛教建議之參考。

Advancing medical technology has made organ transplantation an emerging surgical treatment option for organ failure. Patients who receive transplants must take immunosuppressive agents for the remainder of their life in order to maintain good graft function. Failure to take these agents may affect the function of the transplanted graft, reduce quality of life, and even cause death. Thus, encouraging patients to take immunosuppressive agents as directed is critical to minimizing the long-term medical burdens and social costs of organ transplantation. The purpose of this study is to explore the factors associated with adherence to immunosuppressive therapy among transplant recipients using the WHO adherence model. Findings are provided as a reference to health education and clinical care planners.