影響氣喘病患使用吸入型藥物之因素探討

本研究目的在探討影響氣喘病患使用吸入型藥物的影響因素，採用描述性研究分析病患的基本屬性特性與藥物認知、使用感受、接受態度的程度分析。本研究樣本取自於中部某醫學中心內科門診之病患，研究者以結構式問卷進行訪談，共計收案183人，以SAS統計軟體進行描述性統計分析、t 檢定、變異數分析(ANOVA)、皮爾森相關係數(Pearson’s Correlation Coefficient)分析、邏輯迴歸及多變數分析法找出影響使用吸入型藥物的認知、接受態度、使用感受間之重要因子及其相關性。研究結果顯示：1.影響吸入型藥物的整體認知因子中以年齡、教育程度、氣喘家族史、吸菸習慣等因素均達統計上相關(p<0.05)；顯示年長者、教育程度低者、無氣喘家族史者、吸菸者，應加強吸入型藥物的認知與提供衛生教育的需求。2.用藥接受態度與藥物的認知呈正相關(p<0.01)；顯示加強病患對藥物認知的程度，可同時提昇對藥物的接受度，亦可降低氣喘病患使用吸入型藥物的阻礙，進而強化病患服藥的信心與認同。3.用藥接受態度與方便性及熟練度具有正相關(p<0.01)，顯示方便且易操作的藥物較為病患接受，再者將服藥行為生活化才能達到有效的疾病控制。4.加強病患對藥物的認知程度則能提昇對藥物的接受度，並感受到使用吸入型藥物的方便性與有效性，才能導向規則性的服藥行為，進而改變用藥熟練度以達到有效的治療目的。建議於疾病過程中各項衛生教育應重視持續性，以彌補疾病初期衛生教育指導後產生的遺忘與錯誤認知，並加強中、重度病患認知上的缺失。

The present study aimed at investigating various effects on inhaled therapy for asthma, including patients’ personal attributes, and their understanding of the therapy, feelings toward the use of the therapy and their acceptance attitude. One hundred and eighty-three subjects were recruited from the patients in a medical center located in the central Taiwan. They were interviewed with a structured questionnaire.The data were analyzed with SAS package by descriptive statistical analysis, t-test, analysis of variance, Person’s correlation coefficient, logistic regression and multi-variate analysis. The results reveal (1) Ages, education levels, family history of asthma, and cigarette smoking were significantly correlated (p<0.05) with patients’ understanding of the therapy, indicating that there is a strong need for the health education to the elderly, patients with minimal education, patients with no family history of asthma, and smokers; (2) There was a positive correlation (p<0.01) between patients’ acceptance attitude and their understanding of the therapy. Enhancing their understanding increased their acceptance level and their confidence in the therapy; (3) There was a positive correlation (p<0.01) among patients’ acceptance attitude, the convenience of the usage of the therapy, and their skills in using it correctly, demonstrating that easily manipulated and convenient medicine revealed a high level of acceptance and the asthma would be controlled more effectively when the therapy was considered as part of patients’ daily life activities; and (4) Strengthening patients’ understanding of the therapy increased their acceptance level and their recognition of its’ convenience and efficiency which resulted in their use of regular therapy behavior and improvement in their skills in using it. The results of this study suggest that health education should be persistently conducted to decrease the patients’ misconception and their forgetting at the early stage of the education and to correct the misconception of mild & server patient disease. Key words: Asthma Patient, Inhaled Therapy