邵阳市社区缺血性脑卒中患者服药与功能锻炼依从性调查

Survey on medication adherence and functional training exercise compliance in patients with ischemic stroke in the community of Shaoyang city

目的调查邵阳市社区缺血性脑卒中患者服药和功能锻炼的依从性,并分析其相关影响因素。方法选取2018年10月至2019年10月,邵阳市管辖范围内9个社区的缺血性脑卒中患者142例,记录其相关临床资料。采用Morisky服药依从性量表和功能锻炼依从性量表对患者服药和功能锻炼的依从性进行评分。采用单因素和多因素logistic回归模型分析患者服药和功能锻炼依从性的影响因素。结果单因素分析显示,经济来源于退休金、丧偶、看护人为护工、无医疗保险、文化程度初中及以下、自理程度差、病程长均是服药依从性的影响因素(χ^(2)=5.016、4.562、4.275、6.826、7.628、8.472、11.264,P=0.038、0.041、0.043、0.024、0.011、0.002、0.000)。年龄≥60岁、职业为务农、丧偶、看护人为护工、自理程度差、中风次数多、性格内向型均是功能锻炼依从性的影响因素(F=7.594、4.619、5.081、6.183、10.872、4.154、6.738,P=0.015、0.042、0.039、0.029、0.000、0.045、0.022)。多因素logistic分析显示,丧偶、看护人为护工、无医疗保险、文化程度低、自理程度差均是服药依从性的危险因素(χ^(2)=4.254、8.757、5.159、5.328、5.627,P=0.029、0.005、0.021、0.017、0.012)。职业为务农、丧偶、看护人为护工、自理程度差、中风次数多均是功能锻炼依从性的危险因素(χ^(2)=6.581、6.152、5.159、6.058、6.025,P=0.009、0.012、0.021、0.011、0.011)。结论婚姻状况为丧偶、看护人为护工、无医疗保险、文化程度低、自理程度差均是影响邵阳市社区缺血性脑卒中患者服药依从性的危险因素,职业为务农、婚姻状况为丧偶、看护人为护工、自理程度差、中风次数多均是影响患者功能锻炼依从性的危险因素。

Objective To discuss the medication adherence and functional training exercise compliance in patients with ischemic stroke in the community of Shaoyang city,and to analyze the related influencing factors.Methods Clinical data of 142 patients with ischemic stroke in 9 communities in Shaoyang city from October 2018 to October 2019 were recorded.Morisky medication adherence scale and functional exercise compliance scale were used to score patients’compliance with medication and functional exercise.Univariate and multivariate logistic regression models were used to analyze the influencing factors of medication compliance and functional exercise compliance.Results Univariate analysis showed that the major influencing factors for medication adherence were pension as only income,being widowed,cared by personal care attendant,no health insurance,low education level,poor self-care ability and long course of disease(χ^(2)=5.016,4.562,4.275,6.826,7.628,8.472,11.264,P=0.038,0.041,0.043,0.024,0.011,0.002,0.000).Age of≥60 years,farmer,being widowed,cared by personal care attendant,poor self-care,mutiple strokes and introverted personality were influencing factors for functional exercise compliance(F=7.594,4.619,5.081,6.183,10.872,4.154,6.738,P=0.015,0.042,0.039,0.029,0.000,0.045,0.022).Multivariate logistic regression analysis showed that being widowed,cared by personal care attendant,no medical insurance,low education level and poor self-care were risk factors for medication adherence(χ^(2)=4.254,8.757,5.159,5.328,5.627,P=0.029,0.005,0.021,0.017,0.012),while farmer,being widowed,cared by personal care attendant,poor self-care and multiple strokes were risk factors for compliance with functional exercise(χ^(2)=6.581,6.152,5.159,6.058,6.025,P=0.009,0.012,0.021,0.011,0.011).Conclusions Being widowed,cared by personal care attendant,no health insurance,low education level,poor self-care ability and long course of disease are risk factors for mediation adherence of patients with ischemic stroke,while farmer,being widowed,cared by personal care attendant,poor self-care,mutiple strokes are risk factors for functional excise compliance.