上海市农村居民自我药疗行为环节及风险的质性研究

A Qualitative Research on the Steps and Risks of Self-medication of Shanghai Rural Residents

目的探寻居民自我药疗决策行为的环节及可能发生的风险,以提高居民在自我药疗过程中的安全意识,为相关部门提出降低自我药疗风险的策略提供依据。方法采用现象学研究方法,对10名上海市农村居民就自我药疗行为及风险进行半结构式访谈,并采用Colaizzi的现象学分析法进行资料处理与分析。结果自我药疗决策行为包括药物获取、药物使用及药效自评3个环节。不合理的自我药疗可导致掩盖严重病情、延误治疗、引发严重的不良反应、使疾病恶化甚至威胁生命等风险,且可影响个人履行家庭职责,增加就医成本和加重家庭的经济负担。讨论自我药疗是一个完整的决策过程,必然存在一定的风险,且任何一个环节中出现差错均会导致风险的发生。在保证合理安全的自我药疗中,获取正确的药物是其前提,正确地使用药物是关键,注意用药后效果评价及正确的不良反应处理是保障。

Objective To explore the steps and risks of self-medication decision-making behaviors,so as to improve the safety awareness of residents and provide a basis for the government to develop the policies to lower the risks of self-medication.MethodsPhenomenological research method was used to conduct a semi-structured interview in 10 persons in Shanghai rural areas upon their self-medication decision-making behaviors and risks.The data were analyzed with Colaizzi＇s phenomenological analysis.ResultsThere were three steps of self-medication,including drug access,drug use and drug effect evaluation.Unreasonable self-medication may cover up serious illness,result in delays in treatment,produce serious adverse reactions,cause disease progression even life-threatening,and increase the family burden.ConclusionSelf-medication is a decision-making process,where any step errors may lead to risks.To decrease the risk of self-medication,both medical institutions and the residents should think highly of the three steps：getting right drugs serves as the precondition,correct use of drugs as the key,and exact detection of drug effects and adverse reactions as the assurance.