Abstract:

Objective To explore the influencing factors of medication experience in patients with schizophrenia based on benefit-risk perception. Methods Patients with stable schizophrenia who were hospitalized in 2 tertiary psychiatric hospitals in Heilongjiang Province from September to December 2023 were selected by convenience sampling method. A convergent mixed method was adopted. In quantitative study，data of 400 patients were collected by general situation questionnaire，Subjective Well-being Under Neuroleptic Treatment Scale，the Living with Medicines Questionnaire，Beliefs about Medication Questionnaire，Positive and Negative Syndrome Scale. Binary logistic regression analysis was used to explore the influencing factors of medication experience in patients with schizophrenia. 15 patients with adverse medication experience in quantitative study were selected for qualitative study，and the interview data were sorted and analyzed according to the topic frame analysis method. Results Quantitative results: medication burden, medication beliefs, and psychiatric symptoms of patients with schizophrenia were influential factors of medication experience（P<0.05）. Qualitative results: the medication experience of schizophrenia patients includes 4 themes，namely perceived necessity of medication，perceived benefit of medication， perceived risk of medication, and the need for multi-party cooperation to improve the medication experience. The results of quantitative and qualitative research are complementary in terms of perceived benefit，consistent in terms of perceived risk，and expansive in terms of perceived value. Conclusion Psychiatric nurses can reduce patients’ perceived risk of medication，enhance the perceived benefit of medication，and then improve patients’ adverse medication experience and promote mental rehabilitation.

Key words: Schizophrenia, Medication Experience, Medication Burden, Medication Belief, Mixed Methods, Nursing Care

摘要：

目的 探讨基于获益-风险感知的精神分裂症患者用药体验的影响因素。方法 采用便利抽样法，选取2023年9月—12月黑龙江省某2所三级甲等精神专科医院住院的400例稳定期精神分裂症患者作为研究对象。采用聚敛式混合研究设计，定量研究采用一般情况调查表、抗精神病药治疗中主观舒适度量表、药物生活问卷、服药信念量表、阳性和阴性症状量表进行调查，采用二元Logistic回归分析探究精神分裂症患者用药体验的影响因素。选择定量研究中存在不良用药体验的15例患者进行定性研究，并按照主题框架分析法对访谈资料进行整理与分析。结果 定量研究结果：精神分裂症患者的用药负担、用药信念、精神症状是用药体验的影响因素（P<0.05）。定性研究结果：精神分裂症患者用药体验包括4个主题，即药物治疗必要性感知、药物治疗获益感知、药物治疗风险感知和改善用药体验需多方合作。混合研究结果：精神分裂症患者用药体验影响因素在感知获益方面表现为互补性，在感知风险方面表现为一致性，在感知价值方面表现为扩展性。结论 精神科护士可通过降低患者用药感知风险，增强用药感知获益，进而改善患者不良用药体验，促进精神康复。

关键词: 精神分裂症, 用药体验, 用药负担, 用药信念, 混合方法, 护理