慢性阻塞性肺疾病患者激素吸入治疗依从性及影响因素分析

Compliance of Glucocorticoid Inhalation of Patients with COPD and Its Influencing Factors

目的比较慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者急性加重期和稳定期糖皮质激素吸入治疗的依从性,分析稳定期患者糖皮质激素吸入依从性差的原因,提出护理对策。方法选择197例COPD患者,采用依从性指数调查患者急性加重期和稳定期激素吸入治疗的依从性情况;对依从性一般及差的患者用自行设计的影响因素调查表进行问卷调查。结果197例患者急性加重期激素吸入治疗依从性好为100%;稳定期患者激素吸入治疗依从性指数为(59.6±2.8)%,依从性好占9.7%、一般29.4%、差60.9%。影响稳定期激素吸入治疗依从性的主要因素包括:对疾病知识缺乏认识、担心激素的不良反应、常遗忘使用、持续吸入一段时间后症状控制不理想认为药物无效等。结论COPD急性加重期患者激素吸入治疗依从性好,但患者稳定期激素吸入依从性低,对COPD患者进行长期系统的教育和管理,丰富患者疾病相关知识,加强患者对激素吸入应用的认识,是提高COPD稳定期患者激素吸入依从性的关键。

Objective To compare the compliance of glucocorticoid inhalation of patients with chronic obstructive pulmonary disease（COPD） in different disease stages and to analyze the reasons for poor compliance.Methods A self-designed questionnaire was applied among patients with poor compliance of glucocorticoid inhalation which was identified through compliance index.Results All the patients kept good compliance during acute exacerbation while compliance index for stable patients reached（59.6±2.8）%,only with a good compliance of 9.7%.Factors exerted influence on the compliance of glucocorticoid inhalation included lack of disease knowledge,concerning of adverse effects of glucocorticoid,poor memory and without effective results.Conclusion Patients only keep good compliance during acute exacerbation.While for stable patients,their compliance remains poor.Systematic education and management are essential for improving the compliance of glucocorticoid inhalation of stable patients with COPD.