Berben Lut, Dobbels Fabienne, Engberg Sandra, Hill Martha N, De Geest Sabina
University of Basel, Switzerland.
West J Nurs Res. 2012 Aug;34(5):635-53. doi: 10.1177/0193945911434518. Epub 2012 Feb 6.
Adherence to a prescribed medication regimen is influenced not only by characteristics of the individual patient, but also by factors within the patient's environment, or so-called system level factors. Until now, however, health care system factors have received relatively little attention in explaining medication nonadherence. Ecological models might serve as a framework to help explain the influence of health care system factors on patient behavior (e.g., adherence). In an ecological model, different levels of factors influence patients' behavior, i.e. factors at the patient-level, micro- (provider and social support), meso- (health care organization), and macro (health policy) -levels. In order to understand medication adherence and implement interventions to improve medication adherence, factors at these different levels should be taking into consideration. This paper describes an ecological model compromised of the most important factors at the patient-, micro-, meso- and macro-levels.
坚持规定的药物治疗方案不仅受到个体患者特征的影响，还受到患者环境中的因素，即所谓的系统层面因素的影响。然而，到目前为止，医疗保健系统因素在解释药物治疗不依从性方面受到的关注相对较少。生态模型可能作为一个框架，有助于解释医疗保健系统因素对患者行为（如依从性）的影响。在生态模型中，不同层面的因素会影响患者的行为，即患者层面、微观层面（提供者和社会支持）、中观层面（医疗保健组织）和宏观层面（卫生政策）的因素。为了理解药物治疗依从性并实施干预措施以提高药物治疗依从性，应考虑这些不同层面的因素。本文描述了一个由患者、微观、中观和宏观层面最重要因素组成的生态模型。
