老年人睡眠障碍患者抑郁与服药依从性的关系
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摘要
目的探讨老年人睡眠障碍患者抑郁与服药依从性的关系,以及自我效能感在两者之间的中介作用。方法 2017年6月至2017年12月选取赣州市260名老年人睡眠障碍患者为研究对象,进行老年人抑郁量表、自我效能感问卷和Morisky服药依从性量表调查。结果老年人睡眠障碍患者抑郁的平均分显著高于中等临界值(P<0.001),自我效能感平均分显著低于中等临界值(P<0.05),药物依从性的平均分处于药物依从性中等水平;抑郁、自我效能感与服药依从性三者存在显著相关(P<0.01);分层回归分析结果表明,老年人睡眠障碍患者抑郁和自我效能感均能显著预测其服药依从性,自我效能感在抑郁与服药依从性关系间起部分中介作用。结论老年人睡眠障碍患者抑郁水平可以直接影响其服药依从性,同时又通过自我效能感的中介作用对其服药依从性产生间接影响。
Objective To investigate the relationship of depression and medication adherence among older patients with sleep disturbance, including the mediating role of self-efficacy. Methods 260 older patients with sleep disturbance were investigated by GDS-15, GSES and Morisky Medication Adherence Scale in Ganzhou city from June 2017 to December 2017. Results The average of depression was significantly higher than medium critical value(P<0.001), the average of self-efficacy was lower than medium critical value, the average of medication adherence was at the middle level(P<0.05). There were significant correlations among depression, self-efficacy and medication adherence(P<0.01). The results of layered regression showed that depression and self-efficacy could significantly predict medication adherence. Conclusion The effect of depression can directly affect medication adherence of older patients with sleep disturbance, and also indirectly influence it through self-efficacy.
Objective To investigate the relationship of depression and medication adherence among older patients with sleep disturbance, including the mediating role of self-efficacy. Methods 260 older patients with sleep disturbance were investigated by GDS-15, GSES and Morisky Medication Adherence Scale in Ganzhou city from June 2017 to December 2017. Results The average of depression was significantly higher than medium critical value(P<0.001), the average of self-efficacy was lower than medium critical value, the average of medication adherence was at the middle level(P<0.05). There were significant correlations among depression, self-efficacy and medication adherence(P<0.01). The results of layered regression showed that depression and self-efficacy could significantly predict medication adherence. Conclusion The effect of depression can directly affect medication adherence of older patients with sleep disturbance, and also indirectly influence it through self-efficacy.
引文
[1]刘芸,董永梅,李晓云,等.中国60岁以上老年人睡眠障碍患病率的Meta分析[J].现代预防医学,2014,41(8):1442-1449.
[2] Rajpura J, Nayak R. Medication adherence in a sample of elderly suffering from hypertension:Evaluating the influence of illness perceptions, treatment beliefs, and illness burden[J]. Journal of Managed Care Pharmacy, 2014,20(1):58-65.
[3] Bautista LE, Vera-Cala LM, Colombo C, et al. Symptoms of depression and anxiety and adherence to antihypertensive medication[J]. American Journal of Hypertension, 2012,25(4):505-511.
[4]唐丹.简版老年抑郁量表(GDS-15)在中国老年人中的使用[J].中国临床心理学杂志,2013,21(3):402-405.
[5] Zhang JX, Schwarzer R. Measuring optimistic self-beliefs a Chinese adaptation of the general Self-efficacy Scale[J]. Psychology, 1995,38(3):174-181.
[6] Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting[J]. The Journal of Clinical Hypertension, 2008,10(5):348-354.
[7]陈凡凡,杨连招,胡艳宁,等.人格特征与社区高血压患者服药依从性关系及应对方式中介作用[J].中国健康心理学杂志,2016,24(11):1626-1629.
[8] Burnier M. Medication adherence and persistence as the cornerstone of effective antihypertensive therapy[J]. American Journal of Hypertension, 2006, 19(11):1190-1196.
[9]王敬兰.老年人睡眠障碍原因分析进展[J].中国老年学杂志,2012,32(1):212-213.
[10]汪瑶,杨斯棋,王卫红.湖南农村老年人睡眠障碍与焦虑、抑郁的相关性研究[J].湖南师范大学学报,2016,13(2):34-36.
[11] Cene CW, Dennison CR, Powell HW, et al. Antihypertensive medication nonadherence in black men:Direct and mediating effects of depressive symptoms,psychosocial stressors, and substance use[J]. The Journal of Clinical Hypertension, 2013,15:201-209.
[12]龚立超,陈长香,姚锡娟,等.老年公寓老年人睡眠障碍与抑郁的相关性分析[J].现代预防医学,2012,39(16):4175-4178.
[13]郭君君.老年人自我效能感:保护因素与非保护因素的影响[J].中国健康心理学杂志,2017,4:617-621.
[14] Son YJ, Kim SH, Park JH. Role of depressive symptoms and self-efficacy of medication adherence in Korean patients after successful percutaneous coronary intervention[J]. International Journal of Nursing Practice, 2014,20(6):564-572.
[2] Rajpura J, Nayak R. Medication adherence in a sample of elderly suffering from hypertension:Evaluating the influence of illness perceptions, treatment beliefs, and illness burden[J]. Journal of Managed Care Pharmacy, 2014,20(1):58-65.
[3] Bautista LE, Vera-Cala LM, Colombo C, et al. Symptoms of depression and anxiety and adherence to antihypertensive medication[J]. American Journal of Hypertension, 2012,25(4):505-511.
[4]唐丹.简版老年抑郁量表(GDS-15)在中国老年人中的使用[J].中国临床心理学杂志,2013,21(3):402-405.
[5] Zhang JX, Schwarzer R. Measuring optimistic self-beliefs a Chinese adaptation of the general Self-efficacy Scale[J]. Psychology, 1995,38(3):174-181.
[6] Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting[J]. The Journal of Clinical Hypertension, 2008,10(5):348-354.
[7]陈凡凡,杨连招,胡艳宁,等.人格特征与社区高血压患者服药依从性关系及应对方式中介作用[J].中国健康心理学杂志,2016,24(11):1626-1629.
[8] Burnier M. Medication adherence and persistence as the cornerstone of effective antihypertensive therapy[J]. American Journal of Hypertension, 2006, 19(11):1190-1196.
[9]王敬兰.老年人睡眠障碍原因分析进展[J].中国老年学杂志,2012,32(1):212-213.
[10]汪瑶,杨斯棋,王卫红.湖南农村老年人睡眠障碍与焦虑、抑郁的相关性研究[J].湖南师范大学学报,2016,13(2):34-36.
[11] Cene CW, Dennison CR, Powell HW, et al. Antihypertensive medication nonadherence in black men:Direct and mediating effects of depressive symptoms,psychosocial stressors, and substance use[J]. The Journal of Clinical Hypertension, 2013,15:201-209.
[12]龚立超,陈长香,姚锡娟,等.老年公寓老年人睡眠障碍与抑郁的相关性分析[J].现代预防医学,2012,39(16):4175-4178.
[13]郭君君.老年人自我效能感:保护因素与非保护因素的影响[J].中国健康心理学杂志,2017,4:617-621.
[14] Son YJ, Kim SH, Park JH. Role of depressive symptoms and self-efficacy of medication adherence in Korean patients after successful percutaneous coronary intervention[J]. International Journal of Nursing Practice, 2014,20(6):564-572.