Abstract:

Objective To explore the influencing factors of family participation in medication safety of aged patients with multi-morbidity，and to provide references for clinical practice. Methods Based on capability，opportunity and motivation-behavior model，17 family caregivers of aged patients with multi-morbidity at 8 communities of Zhengzhou，Henan Province from September to November 2024 were selected for semi-structured interviews using purposive sampling method. The data were analyzed using directed content analysis. Results Facilitators of family participation behavior included ability factors（strong self-reflection and emotional regulation ability），opportunity factors（family and peer support，professional support from medical staff），motivational factors （par-ticipation in medication safety importance perception，high level of participation self-efficacy，strong sense of responsibility）. Barriers of family participation behavior included ability factors（the family caregivers’ own aging and disease limitations，and the family caregivers’ medication safety management ability is insufficient），opportunity factors（the excessive physical and mental independence of the patients，the multiple role conflict of the family caregivers）. Conclusion There are some facilitators and barriers in the process of family participation in medication safety of elderly patients with multi-morbidity. Medical staff should attach importance to family participation experience，adopt targeted strategies to promote family participation in medication safety of elderly patients with multi-morbidity，so as to promote disease recovery.

Key words: Aged, Multi-Morbidity, Family Participation, Medication Safety, Capability, Opportunity, and Motivation-Behavior Model, Qualitative Study, Nursing Care

摘要：

目的 探讨家庭参与老年慢性病共病患者用药安全的影响因素，为临床实践提供参考。方法 基于能力、机会、动机-行为模型，采用目的抽样法，于2024年9月—11月选取河南省郑州市8个社区卫生服务中心的17名老年慢性病共病患者的家庭照顾者进行半结构式访谈，使用定向内容分析法进行资料分析。结果 家庭参与老年慢性病共病患者用药安全促进因素主要包括能力因素（较强的自我反思与情绪调节能力）、机会因素（家庭及朋辈支持、医护人员的专业支持）、动机因素（参与用药安全的重要性感知、高水平的参与自我效能、强烈的责任感）；障碍因素包括能力因素（家庭照顾者自身的衰老及疾病限制、家庭照顾者用药安全管理能力不足）、机会因素（患者过高的身心独立性、家庭照顾者所承担的多重角色冲突）。结论 家庭参与老年慢性病共病患者用药安全过程中存在一定的阻碍因素，也有明显的促进性因素，医护人员应当重视家庭参与体验，采取针对性策略促进家庭参与老年慢性病共病患者的用药安全，促进患者疾病康复。

关键词: 老年人, 慢性病共病, 家庭参与, 用药安全, 能力、机会、动机-行为模型, 质性研究, 护理