慢性心力衰竭患者居家用药安全影响因素的质性研究

Influencing factors of home medication safety in patients with chronic heart failure:a qualitative study

目的基于健康行为改变整合理论探讨慢性心力衰竭(chronic heart failure,CHF)患者居家用药安全的影响因素。方法采用描述性质性研究方法,通过目的抽样,选取2022年12月—2023年5月湖南省长沙市3所医院心血管内科病区的22例CHF患者进行半结构式深度访谈,借助NVivo 11.0软件整理和编码资料,采用定向主题分析法分析资料。结果共提炼出知识(疾病知识、用药安全知识)、态度与信念(疾病态度、服药信念)、自我调节(参与用药安全的自我管理、在经验中成长)、社会促进(医院咨询服务、家庭成员支持、客观情境干扰)4个主题和9个亚主题。结论知识、信念、自我调节和社会促进相互联系,共同影响CHF患者居家用药安全行为。医护人员、家庭成员和社会应为患者提供用药安全信息、营造支持性环境,重点提高患者自我调节的意识和能力,坚定其服药信念,保障CHF患者居家用药安全。

Objective Based on the Integrated Theory of Health Behavior Change(ITHBC),the influencing factors of home medication safety were explored in patients with chronic heart failure(CHF).Methods This qualitative description,involving a semi-structured in-depth interview of 22 CHF patients based on purposive sampling,was conducted from December 2022 to May 2023,at 3 hospitals in Changsha,Hunan.NVivo 11.0 software was used to organize and code data,and content analysis was performed to analyze data.Results Totally 9 generic categories belonging to 4 categories were extracted.These were knowledge(knowledge of disease and knowledge of medication safety),attitude and belief(attitude towards diseases and medication belief),self-regulation(participation in medication safety self-management and growing through experience),and social facilitation(hospital consultation services,family support and objective situation interference).Conclusion Knowledge,belief,self-regulation and social facilitation were interrelated to influence medication safety behavior of patients with CHF at home.Medical workers,family members and society should work together to provide medication safety information,create a supportive environment,focus on improving patients’awareness and ability of self-regulation,strengthen their belief in taking medication,and ultimately ensure the home medication safety for CHF patients.