慢性心力衰竭患者居家用药安全影响因素的质性研究

doi:10.3761/j.issn.0254-1769.2024.14.007

摘要/Abstract

摘要：

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。

关键词: 健康行为改变整合理论, 慢性心力衰竭, 居家用药, 用药安全, 质性研究, 护理

Abstract:

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.

Key words: Integrated Theory of Health Behavior Change, Chronic Heart Failure, Home Medication, Medication Safety, Qualitative Study, Nursing Care

程玲, 郑凤, 惠梦湲, 钟竹青. 慢性心力衰竭患者居家用药安全影响因素的质性研究[J]. 中华护理杂志, 2024, 59(14): 1713-1718.

CHENG Ling, ZHENG Feng, HUI Mengyuan, ZHONG Zhuqing. Influencing factors of home medication safety in patients with chronic heart failure：a qualitative study[J]. Chinese Journal of Nursing, 2024, 59(14): 1713-1718.

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