患者服用中药汤剂依从性评价方法研究

Study on Establishment of Compliance Evaluation Methods for Patients Taking TCM Decoctions

目的建立以出现不合理现象的程度和权重赋分评价患者服用中药汤剂总体依从性的方法。方法选取本院2010年7-12月服用中药汤剂的患者作为调查对象,采用自制量表进行问卷和访谈综合调查,以服用中药汤剂过程中出现不合理现象的程度和权重赋分作为评价依从性的指标(0:完全依从;0<X≤0.5:依从性较好;0.5<X≤2:依从性较差;2<X:完全不依从)。结果按患者综合得分分级后的依从性人群分布为:完全依从占21.13%,依从性较好占30.28%,依从性较差占45.07%,完全不依从占3.52%。依从性等级与自觉疗效等级呈等级正相关(rs=0.919 9;P=0.000 003);依从性"较好"与"较差"、"好"(完全依从与依从性较好)与"差"(依从性较差与完全不依从)相比,自觉有效率差异均有统计学意义(P<0.05)。"依从性好"不适症状发生比例低于"依从性差"的人群,但差异无统计学意义。结论以出现不合理现象的程度和权重赋分作为评价患者服用中药汤剂依从性的指标而建立的"服用中药汤剂总体依从性评价方法"具有可操作性和实用意义。

Objective To establish evaluation methods for compliance of patients taking Chinese medicine decoctions, according to the score of degree and weight for the unreasonable behaviors. Methods The patients taking TCM decoctions during July to December in 2010 were interviewed. Self-made scale was used for questionnaire and interview. The score of degree and weight for the unreasonable behavior were employed as evaluation indexes for compliance （0：complete compliance;0〈X≤0.5：good compliance;0.5〈X≤2：bad compliance;2〈X：completely no compliance）.ResultsAccording to the grades of the score of degree and weight for the unreasonable behavior, the population distributionswere： the rate of complete compliance was 21.13%;the rate of the good compliance was 30.28%;the rate of bad compliance was 45.07%;the rate of completely no compliance was 3.52%. There was a positive correlation between compliance grade and subjective curative effect grade （rs=0.9199;P=0.000003）. There was a significant difference of the subjective effective rate between good complication and bad complication, with statistical significance between differences in subjective effective rates （P〈0.05）. The incidence of discomfort symptoms in patients with good complication was lower than that in patients with bad complication, without statistical significance. ConclusionThe evaluation methods for compliance of patients taking Chinese medicine decoctions based on the score of degree and weight for the unreasonable behavior are operable and practical.