Sun Yujing, Yu Hong, Wang Zhengjun, Zhang Jing, Zhou Yuqiu, Cui Wenming, Jiang Wenlong
Department of Nursing, Harbin Medical University Daqing Campus, Daqing, China.
The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China.
BMC Nurs. 2024 Mar 22;23(1):197. doi: 10.1186/s12912-024-01882-4.
Individuals with schizophrenia require prolonged antipsychotic medication treatment. But more than 50% of individuals with schizophrenia experience adverse medication experiences during their antipsychotic treatments. Such individuals often adjust or discontinue medication, leading to disease relapse and impaired social functioning. Psychiatric nurses should pay close attention to the medication experiences of individuals with schizophrenia. This research explore the relationship between medication burden and medication experience, as well as the mediating effect of medication belief in stable patients with schizophrenia.
A convenience sample of hospitalized stable patients with schizophrenia were selected from Daqing Third Hospital and Baiyupao Hospital from September 2023 to December 2023. A survey was conducted with them using a questionnaire consisting of general information questionnaire, The Subjective Well-being Under Neuroleptic Treatment Scale(SWN), The Living with Medicines Questionnaire(LMQ), Beliefs about Medicines Questionnaire-Specific (BMQ-Specific). Pearson correlation analysis was used to explore the correlation between LMQ, BMQ-Specific and SWN scores, and multiple linear regression analysis was used to explore the influencing factors of medication experience in patients with schizophrenia. AMOS 24.0 was used to construct the structural equation modeling(SEM), and the mediation effect of the SEM was tested using Bootstrap method.
According to the sample size calculation requirements of structural equation model, a total of 300 samples were required in this study, and 400 effective questionnaires were actually collected in this study, which met the sample size requirements for constructing structural equation models. Bootstrap test showed that the mediation effect was significant. The total effect of medication burden on medication experience was significant (Z=-12.146, 95%CI (-0.577, -0.417), P < 0.001). The indirect effect of medication burden on medication experience, that is, the mediating effect of medication belief was significant (Z=-4.839, 95%CI (-0.217, -0.096), P < 0.001). The direct effect of medication burden on medication experience was significant (Z=-7.565, 95%CI (-0.437, -0.257), P < 0.001). This model belongs to partial mediation model.
Psychiatric nurses can enhance the patients' medication experience by reducing medication burden and strengthening medication beliefs. Therefore, the results also provide theoretical references and decision-making foundations for psychiatric nursing professionals to develop appropriate management strategies for individuals with schizophrenia.
精神分裂症患者需要长期使用抗精神病药物治疗。但超过50%的精神分裂症患者在抗精神病治疗期间会经历不良用药体验。这类患者常调整或停用药物，导致疾病复发和社会功能受损。精神科护士应密切关注精神分裂症患者的用药体验。本研究探讨用药负担与用药体验之间的关系，以及用药信念在稳定期精神分裂症患者中的中介作用。
选取2023年9月至2023年12月在大庆市第三医院和白鱼泡医院住院的稳定期精神分裂症患者作为便利样本。使用由一般信息问卷、抗精神病药物治疗下的主观幸福感量表（SWN）、药物生活问卷（LMQ）、特定药物信念问卷（BMQ-Specific）组成的问卷对他们进行调查。采用Pearson相关分析探讨LMQ、BMQ-Specific与SWN得分之间的相关性，采用多元线性回归分析探讨精神分裂症患者用药体验的影响因素。使用AMOS 24.0构建结构方程模型（SEM），并采用Bootstrap法检验SEM的中介效应。
根据结构方程模型的样本量计算要求，本研究共需要300个样本，实际收集有效问卷400份，满足构建结构方程模型的样本量要求。Bootstrap检验显示中介效应显著。用药负担对用药体验的总效应显著（Z=-12.146，95%CI（-0.577，-0.417），P<0.001）。用药负担对用药体验的间接效应，即用药信念的中介效应显著（Z=-4.839，95%CI（-0.217，-0.096），P<0.001）。用药负担对用药体验的直接效应显著（Z=-7.565，95%CI（-0.437，-0.257），P<0.001）。该模型属于部分中介模型。
精神科护士可通过减轻用药负担和强化用药信念来提升患者的用药体验。因此，研究结果也为精神科护理专业人员为精神分裂症患者制定合适的管理策略提供了理论参考和决策依据。
