基于ROMI的住院精神分裂症患者服药依从性及相关因素研究

Study on medication compliance and related factors of inpatients with schizophrenia by ROMI

目的 探讨住院精神分裂症患者服药依从性及其影响因素。方法 以住院精神病患者为研究对象，采用药物影响因素评定量表（ROMI）作为评定工具，以半结构式访谈的形式评估入院 3周后患者对于抗精神病药物的心理资料，分析ROMI评分与患者人口统计学资料及临床资料的相关性，预测ROMI各因素对依从性的影响程度。结果 患者的人口统计学资料（年龄、学历、工作状态、是否有人监管、住院付费方式）及临床资料（用药种类、病程、住院次数）与 ROMI评分无关（P＞ 0.05），药物不良反应与 ROMI不依从原因分量表得分呈正相关（P＜0.05）。患者遵从专家指示、感受到药物对日常生活的益处、害怕复发、家人或朋友对于服用药物有正面意见等因素在促成依从的主观因素中影响较大（P＜0.01），患者认为药物不良反应较为缓和、药物可以帮助实现个人目标、与医务人员有良好关系是促成依从影响较普遍的因素（P＜0.01）。结论 药物不良反应带来的苦恼是不依从的主观原因中影响较普遍的因素，患者遵从专家指示、感受到药物对日常生活的益处、害怕复发、家人或朋友对于服用药物有正面意见等因素对药物依从性影响较大。

Objective To investigate the compliance and its influencing factors of patients with schizophrenia. Methods The psychological data of antipsychotic drugs were evaluated in the form ofsemi-structured interview after 3 weeks of hospitalization by Rating of Medication Influence Scale （ROMI）. The relevance of demographic data and clinical data were evaluated,and the impact of ROMI factors on compliance was predicted. Results The demographic factors（age,education,working status,supervision,payment）and clinical factors （type of medication,duration of disease,number of hospitalizations）were not associated with ROMI score（P〉0.05）. While drug side effects and ROMI non-compliance scores were positively correlated （P〈0.05）. Patients followed the instructions of experts,felt the benefits of drugs on daily life,feared of recurrence,familymembers or friends had a positive opinion on the use of drugs play an important role among the factors（P〈0.01）. Patients considered that the side effects of drugs were more moderate,the drug could help achieve person-al goals and had a good relationship with medical staff play an important role in impact factors（P〈 0.01）. Conclusions Drug side effects are common factors that affect medication compliance. Following the instructions of the expert,feel the benefits of the drug to the daily life,fear of recurrence,family or friends have a positive opinion on taking the drug are more greater factors which affect medication compliance.