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斐济心脏病患者对影响用药依从性因素的认知:一项定性研究

Patients' Perception of Factors Influencing Noncompliance with Medication among Cardiac Patients in Fiji: A Qualitative Study.

作者信息

Kumar Avnit, Mohammadnezhad Masoud, May William

机构信息

Department of Primary Care and Nutrition, Fiji National University, Suva, Fiji Islands.

Department of Public Health and Health Services Management, Fiji National University, Suva, Fiji Islands.

出版信息

Patient Prefer Adherence. 2021 Aug 24;15:1843-1852. doi: 10.2147/PPA.S322731. eCollection 2021.

Abstract

BACKGROUND

Noncompliance with prescribed medication leads to disease progression, which often leads to premature deaths. It often leads to worsening symptoms of cardiac conditions and hospitalization. Due to the lack of previous research, this study aimed to explore the factors contributing to noncompliance with medication in cardiac patients in Fiji.

METHODS

This qualitative study was conducted among 25 cardiac patients with congestive heart failure and coronary heart disease who attended special outpatient department (SOPD) clinics at Sigatoka Subdivisional Hospital in Fiji. Purposive sampling was used to select the study sample, and in-depth face-to-face interviews were conducted using a semistructured, open-ended questionnaire. Data were analyzed using thematic analysis, whereby the data collected were grouped in subthemes and then common themes related to the topic.

RESULTS

A total of 25 patients were interviewed, with a majority (n=14) being men and 15 Fijian of Indian descent. A greater number (n=17) of participants were above the age of 60 years, 19 had had primary education, while 12 were unemployed. Eight themes were identified as factors affecting noncompliance with medication: scarcity of knowledge, patients' negative attitudes, poor family support, financial constraints, forgetfulness, irregular clinic attendance, heavy alcohol use, and alternative treatment vs pharmaceutical medication.

CONCLUSION

Noncompliance with medication in cardiac patients contributes to worsening cardiac disease and premature deaths. For factors related to noncompliance, awareness can be raised in SOPD clinics for patients to realize the effects of noncompliance and provide ways to improve compliance. Providing professional counseling services for all SOPD patients would greatly help in increasing compliance with medication in Fiji.

摘要

背景

不遵医嘱服药会导致疾病进展,这往往会导致过早死亡。它常常会导致心脏疾病症状恶化并需要住院治疗。由于此前缺乏相关研究,本研究旨在探讨斐济心脏病患者不遵医嘱服药的影响因素。

方法

本定性研究在25名患有充血性心力衰竭和冠心病的心脏病患者中开展,这些患者在斐济西格托卡分区医院的特殊门诊部就诊。采用目的抽样法选取研究样本,并使用半结构化、开放式问卷进行深入的面对面访谈。采用主题分析法对数据进行分析,即将收集到的数据分组为子主题,然后归纳出与该主题相关的共同主题。

结果

共访谈了25名患者,其中大多数(n = 14)为男性,15名是印度裔斐济人。更多(n = 17)参与者年龄在60岁以上,19人接受过小学教育,12人失业。确定了八个影响不遵医嘱服药的因素主题:知识匮乏、患者消极态度、家庭支持不足、经济拮据、健忘、不定期就诊、大量饮酒以及替代疗法与药物治疗。

结论

心脏病患者不遵医嘱服药会导致心脏病恶化和过早死亡。对于与不遵医嘱相关的因素,可在特殊门诊部提高患者的认识,使其认识到不遵医嘱的影响,并提供提高依从性的方法。为所有特殊门诊部患者提供专业咨询服务将极大有助于提高斐济患者的服药依从性。

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