慢性肾脏病患者参与用药安全行为影响因素的混合研究

doi:10.3761/j.issn.0254-1769.2026.13.009

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (13): 1792-1799.DOI: 10.3761/j.issn.0254-1769.2026.13.009

慢性肾脏病患者参与用药安全行为影响因素的混合研究

韩文静¹(), 杨欣茹², 张雪凝³, 孔冬³, 张静⁴^,^*()

¹ 山东第一医科大学附属省立医院急救中心济南市 250021
² 山东第一医科大学附属省立医院乳腺甲状腺外科济南市 250021
³ 山东第一医科大学附属省立医院护理部济南市 250021
⁴ 山东第一医科大学附属省立医院知名专家门诊济南市 250021

收稿日期:2026-01-20 出版日期:2026-07-10 发布日期:2026-07-01
*通讯作者: 张静，E-mail：zhangjingsdu@163.com
作者简介:韩文静：女，硕士，护士，E-mail：1228468561@qq.com
第一联系人：作者贡献声明
韩文静：研究设计、问卷调查、论文撰写；杨欣茹、张雪凝：数据整理、统计学分析；孔冬：研究设计、研究指导；张静：研究设计、研究指导、论文审阅与修改

A mixed study on the influencing factors of medication safety participation in patients with chronic kidney disease

HAN Wenjing¹(), YANG Xinru², ZHANG Xuening³, KONG Dong³, ZHANG Jing⁴^,^*()

¹ Emergency Center， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China
² Department of Breast and Thyroid Surgery， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China
³ Nursing Department， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China
⁴ Renowned Specialist Clinic， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China

Received:2026-01-20 Online:2026-07-10 Published:2026-07-01
* Corresponding author: ZHANG Jing，E-mail：zhangjingsdu@163.com

摘要/Abstract

摘要：

目的调查慢性肾脏病患者参与用药安全行为现状及影响因素，为医护人员制订干预策略提供依据。方法采用聚敛式混合研究设计，便利选取2024年6—12月山东省济南市某三级甲等医院肾内科244例慢性肾脏病患者进行问卷调查，并对其参与用药安全行为的影响因素进行多元线性回归分析；同期制订访谈提纲，采用目的抽样法选取18例患者进行半结构式访谈；采用联合展示法对量性与质性研究结果进行分析。结果量性研究显示，慢性肾脏病患者参与用药安全行为水平总分为（71.45±21.54）分，年龄、健康素养、社会支持、自我效能与抑郁是其参与用药安全行为的主要影响因素（P<0.05）。质性研究共提炼出3个核心主题，即药物安全管理知识与技能欠缺、制约性与支持性因素并存、参与意愿摇摆不定。混合研究结果显示，患者参与用药安全行为有待提高，其影响因素包括个体条件、健康素养、自我效能、心理状态、社会支持水平及医疗资源可及性等。结论医护人员应基于患者个体差异及社会支持水平制订针对性干预措施，提升患者的用药知识与信心，促进其参与用药安全行为。

关键词: 慢性肾脏疾病, 患者参与, 用药安全, 混合研究, 护理

Abstract:

Objective To investigate the current status and influencing factors of medication safety participation among patients with chronic kidney disease，and to provide a basis for healthcare professionals to develop intervention strategies. Methods A convergent mixed study was used. A questionnaire survey was conducted among 244 patients with chronic kidney disease，conveniently sampled at a nephrology of tertiary hospital in Jinan，Shandong Province，from June to December 2024. Multiple linear regression analysis was used to identify factors influencing medication safety participation. Concurrently，semi-structured interviews were conducted with 18 purposefully sampled patients based on an interview guide. Quantitative and qualitative findings were integrated using a joint display analysis. Results The quantitative results showed that the total score of medication safety participation in patients with chronic kidney disease was（71.45±21.54） points，and the main influencing factors included age，health literacy，social support，self-efficacy and depression（P<0.05）. The qualitative study extracted 3 core themes，including lack of medication safety management knowledge and skills，coexistence of constraining and supporting factors，and fluctuating willingness to participate. The mixed-methods study revealed that patients’ participation in medication safety behaviors requires improvement，with influencing factors including individual characteristics，health literacy，self-efficacy，psychological status，level of social support，and accessibility of medical resources. Conclusion Targeted interventions should be developed based on individual differences and social support level to enhance patients’ medication knowledge and confidence，and to promote active participation.

Key words: Chronic Kidney Disease, Patient Participation, Medication Safety, Mixed-Methods Study, Nursing Care

韩文静, 杨欣茹, 张雪凝, 孔冬, 张静. 慢性肾脏病患者参与用药安全行为影响因素的混合研究[J]. 中华护理杂志, 2026, 61(13): 1792-1799.

HAN Wenjing, YANG Xinru, ZHANG Xuening, KONG Dong, ZHANG Jing. A mixed study on the influencing factors of medication safety participation in patients with chronic kidney disease[J]. Chinese Journal of Nursing, 2026, 61(13): 1792-1799.

图/表 6

表1 调查对象一般资料及参与用药安全行为的单因素分析结果(n=244)

Table 1 Univariate analysis of general information and medication safety participation in study participants(n=244)

表2 慢性肾脏病患者参与用药安全行为量表得分（分，$\bar{x}±s$）

Table 2 Scores of medication safety participation in patients with chronic kidney disease（score,$\bar{x}±s$）

表3 自变量赋值表

Table 3 Independent variable assignment table

表4 慢性肾脏病患者参与用药安全行为的多元线性回归分析（n=244）

Table 4 Multiple regression analysis of medication safety participation in patients with chronic kidney disease（n=244）

表5 受访者的一般资料（n=18）

Table 5 General information of respondents（n=18）

表6 量性研究与质性研究结果的整合分析

Table 6 Integrated analysis of quantitative and qualitative findings

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慢性肾脏病患者参与用药安全行为影响因素的混合研究

A mixed study on the influencing factors of medication safety participation in patients with chronic kidney disease

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