摘要
目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者吸入用药行为的障碍因素,为制定针对性干预策略,完善吸入用药管理实践提供依据。方法:采用描述性质性研究方法,基于理论域框架(theoretical domains framework,TDF)设计访谈提纲,以目的抽样法选取2024年11月至2025年2月在青岛市市立医院就诊的14例稳定期COPD患者进行面对面的半结构式访谈。访谈资料以TDF为编码框架,采用定向内容分析法进行资料整理分析。结果:共提炼出3个主题及13个亚主题:管理能力有限(疾病及药物素养低、药物使用技能不足、缺乏优先级设定、自我效能感低下)、行为动机不足(预期效果不佳、消极情绪、病耻感、缺乏目标、目标不坚定)、缺乏外部支持(资源匮乏、缺乏家庭支持、缺乏医疗支持、缺乏社会支持),映射到TDF中的知识、技能、记忆力/注意力/决策、能力信念、结果信念、情绪、目标、环境和资源、社会影响共9个理论域。结论:COPD患者吸入用药行为受多重障碍因素影响,应通过提高用药管理能力、激发行为动机、建立健全支持系统等途径多维度协同干预,以规范COPD患者吸入用药行为,提升其用药依从性。
Objective:To explore the barriers of inhaled medication behavior among patients with chronic obstructive pulmonary disease(COPD),and to provide basis for formulating targeted intervention strategies and improving inhaled medication management practice.Methods:Using descriptive research method,an interview outline was designed based on theoretical domains framework(TDF),and 14 stable COPD patients admitted to Qingdao Municipal Hospital from November 2024 to February 2025 were selected for semi-structured interview using purpose sampling method.The interview data was compiled using TDF as coding framework,and analyzed with targeted content analysis method.Results:A total of 3 themes and 13 sub-themes were extracted,including limited management ability(low disease and medication literacy,insufficient inhaled medication use skills,lack of priority setting,low self-efficacy),insufficient behavioral motivation(poor expected results,negative emotions,stigma,lack of goals,instability of goals),and lack of external support(scarce resources,lack of family support,lack of medical support,lack of social support),which were mapped to 9 theoretical domains in TDF:knowledge,skills,memory/attention/decision-making,ability beliefs,outcome beliefs,emotions,goals,environment and resources,and social impact.Conclusion:Inhaled medication behavior of COPD patients is affected by multiple barriers.Multi-dimensional collaborative intervention should be carried out through improving medication management capabilities,stimulating behavioral motivations,and establishing and improving support systems to standardize the inhaled medication behavior of COPD patients and improve their medication compliance.
作者
王凯选
陈静
吕伯瀚
郝万明
隋风翔
Wang Kaixuan;Chen Jing;Lyu Bohan;Hao Wanming;Sui Fengxiang(Department of Pulmonary and Critical Care Medicine,Qingdao Municipal Hospital,Qingdao 266011,China;Department of Critical Care Medicine,Qingdao Municipal Hospital,Qingdao 266011,China;Department of Nursing,The Affiliated Hospital of Qingdao University,Qingdao 266001,China)
出处
《结核与肺部疾病杂志》
2025年第5期551-557,共7页
Journal of Tuberculosis and Lung Disease
基金
山东省医药卫生科技项目-重点项目(202403020661)。
关键词
肺疾病
慢性阻塞性
投药
吸入
行为
因素分析
定性研究
Pulmonary disease,chronic obstructive
Administration,inhalation
Behavior
Factor analysis
Qualitative research
