高血压性脑梗死低依从性患者服药认知的质性研究

Qualitative research on the perceptions of hypertensive ischemic stroke patients with low medication adherence

目的探索高血压患者脑梗死发病前血压控制不良的原因,为制定脑卒中防治策略提供临床依据.方法采用质性研究中的现象学研究方法于2016年2-6月对广东省3所三甲医院神经内科15例入院血压异常的高血压性脑梗死低依从性患者进行质性访谈.结果采用Colaizzi现象学分析法将患者的服药认知误区归纳为4个主题:认为凭主观感觉可以判断病情,认为是否监测血压、是否忘记服药、是否因各种原因暂停服药与脑梗死的发生关系不大.结论高血压性脑梗死患者发病前的服药认知存在误区,提示应加强高血压患者及高血压性脑梗死患者血压监测及服药依从性的健康教育,从而提高脑卒中一级预防和二级预防的效果.

Objective To explore the reasons of hypertensive patients'uncontrolled blood pressure before onset of ischemic stroke so as to provide clinical evidence for stroke prevention.Methods The phenomenological analysis method in qualitative research was applied.From February to June 2016,15 hypertensive ischemic stroke patients with hypertensive cerebral infarction and low medication adherence admitted to the department of neurology of three tertiary hospitals in Guangdong province were selected and participated in qualitative interviews.Results By Colaizzi phenomenological analysis method,the medication misconception of patients were summarized into 4 themes:estimating physical condition by self-feeling,holding the opinion that there was few relation between"whether monitoring blood pressure","forgetting medication","stopping medication because of various reasons"and cerebral infarction.Conclusions There are some misunderstandings in the cognition of taking medicine before the onset of hypertensive cerebral infarction.It suggests that we should strengthen blood pressure monitoring and health education of drug compliance in hypertensive patients and hypertensive cerebral infarction patients,so as to improve the effect of primary prevention and secondary prevention of stroke.