护理研究2024，Vol.38Issue(2)：246-251,6.DOI:10.12102/j.issn.1009-6493.2024.02.009
基于COM-B模型的老年慢性心力衰竭病人服药依从性影响因素
Influencing factors of medication adherence among older patients with chronic heart failure:an analysis based on COM-B model
摘要
Abstract
Objective:To investigate the status quo of medication adherence among older patients with chronic heart failure,and to analyze pathways of medication literacy,cognitive function,social support,and medication beliefs on medication adherence based on capacity,opportunity,motivation-behavior(COM-B)model.Methods:A total of 412 older patients with chronic heart failure admitted to the Department of Cardiology,Shanghai Fifth People's Hospital,Fudan University were conveniently selected as subjects from January to September 2022.General information questionnaire,Morisky Medication Adherence Scale(MMAS),Mini-Mental State Examination(MMSE),Social Support Rated Scale(SSRS),Medication Literacy Assessment in Spanish and English(MedLitRxSE)and The Beliefs about Medicines Questionnaire-Specific(BMQ-specific)were used for investigation.A structural equation modeling was adopted for path analysis.Results:The MMAS score of older patients with chronic heart failure was 5.75±1.75,189 patients(45.9%)had poor medication adherence.Medication literacy,cognitive function,social support,and medication beliefs had direct impact on medication adherence,and the effect were 0.278,0.099,0.127 and 0.531,respectively.Medication literacy also indirectly affected medication adherence through medication belief,with effect of 0.146.Cognitive function also indirectly affected medication adherence through medication literacy and medication beliefs,with effect of 0.167.Social support also indirectly affected medication adherence through medication literacy,with effect of 0.151.Conclusions:Older patients with chronic heart failure have low medication adherence level.Medication literacy,cognitive function,and social support all affect medication adherence through direct or indirect effects,and medication beliefs directly affect medication adherence.关键词
老年人/心力衰竭/服药依从性/药物素养/认知功能/社会支持/服药信念/路径分析Key words
older adults/chronic heart failure/medication adherence/medication literacy/cognitive function/social support/medication beliefs/path analysis引用本文复制引用
谢传桃,顾艳荭,李玉梅,孙娜,蒋锐杰..基于COM-B模型的老年慢性心力衰竭病人服药依从性影响因素[J].护理研究,2024,38(2):246-251,6.基金项目
复旦大学附属上海市第五人民医院院级医学重点专科建设计划项目,编号:2020WYZDZK10 （）
复旦大学附属上海市第五人民医院院内护理科研课题,编号:2022WYHLZT01 （）
