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影响疾病控制的匈牙利哮喘和 COPD 患者态度:基于健康信念模型的实证研究。

Attitudes of Hungarian asthmatic and COPD patients affecting disease control: empirical research based on Health Belief Model.

机构信息

Health Marketing Research Centre, Institute of Marketing and Media, Corvinus University of Budapest Budapest, Hungary.

出版信息

Front Pharmacol. 2013 Nov 13;4:135. doi: 10.3389/fphar.2013.00135. eCollection 2013.

Abstract

INTRODUCTION

Patient non-adherence to treatment is a major problem across most chronic diseases. In COPD and asthma treatments it is a complex issue because people need to make behavioral and lifestyle changes while taking medications. Poor adherence results in increased rates of morbidity and mortality, more frequent hospitalizations, and ultimately higher healthcare expenditures.

MATERIALS AND METHODS

The objective of the study was to assess asthmatic and COPD patient's attitudes toward adherence in Hungary. Health Belief Model was used to help explain reasons of non-adherence. The results of the study should provide additional support to understanding health-related behaviors and to developing health related programs enhancing adherence of asthmatic and COPD patients. 145 diagnosed COPD patients and 161 diagnosed asthmatic patients were involved in 6 pulmonary centers. The questions were designed to measure Health Belief Model dimensions A 1-5 point verbal Likert scale was used. As a second stage, the answers were compared with the registered patient's personal health data available in pulmonary center's documentation. The data was analyzed using SPSS software.

RESULTS

More than 32% of patients are very interested in new asthma or COPD research results, but their main information source is physician. The trust toward the physician is very high. Patients accept treatments and rarely ask questions. Respondents are cooperative but sometimes fail to follow therapeutic recommendations. There is no willingness to join self-help groups or associations.

DISCUSSION

The paternalistic approach was generally accepted, moreover expected by the patients from the physicians. It is important to train patients, increase their self-efficacy, responsibility and involve them into self-management programs. Both physicians and patients should be trained how to communicate-this approach can lead to increased understanding and better adherence.

摘要

简介

患者不遵守治疗方案是大多数慢性病面临的主要问题。在 COPD 和哮喘的治疗中,这是一个复杂的问题,因为患者需要在服药的同时改变行为和生活方式。较差的依从性会导致发病率和死亡率增加、住院频率增加,最终导致医疗保健支出增加。

材料与方法

本研究的目的是评估匈牙利哮喘和 COPD 患者对依从性的态度。健康信念模型被用于帮助解释不依从的原因。该研究的结果应提供更多支持,以了解与健康相关的行为,并制定增强哮喘和 COPD 患者依从性的相关健康计划。在 6 个肺科中心,共有 145 名确诊的 COPD 患者和 161 名确诊的哮喘患者参与了该研究。问题旨在衡量健康信念模型维度,使用 1-5 分的口头李克特量表进行测量。作为第二阶段,将答案与肺科中心文件中记录的患者个人健康数据进行比较。使用 SPSS 软件对数据进行分析。

结果

超过 32%的患者对新的哮喘或 COPD 研究结果非常感兴趣,但他们的主要信息来源是医生。对医生的信任度非常高。患者接受治疗,很少提问。受访者合作但有时未能遵循治疗建议。他们没有意愿加入自助小组或协会。

讨论

家长式的方法普遍被接受,而且这也是患者对医生的期望。培训患者、提高他们的自我效能、责任感并让他们参与自我管理计划非常重要。医生和患者都应该接受如何沟通的培训——这种方法可以增进理解并提高依从性。

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