社区残疾人药学服务需求现状及差异性研究
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摘要
背景残疾人群是多种疾病的高发人群,目前对于其医疗服务需求的研究多集中在定期体检、上门服务、康复指导等方面,而针对其药学服务需求的研究相对较少。目的了解社区残疾人的药学服务需求,基于基本人口学特征、社会经济地位、残疾类别和残疾等级探讨其药学服务差异。方法于2017年11—12月,采用单纯随机抽样法在上海市某街道的在册残疾人中抽取230例进行问卷调查。主要内容包括:残疾人的基本人口学特征(性别、年龄、婚姻状况)、社会经济地位(文化程度、工作状态、家庭人均月收入)、残疾类别与残疾等级、药学服务需求(需求内容、需求来源、需求程度)。结果共回收有效问卷226份(98.3%)。残疾人的药学服务需求内容排在前2位的为"用法用量及疗程"(73.0%,165/226)、"适应证和禁忌证"(51.3%,116/226);需求来源主要为医生(85.4%,193/226);需求程度为非常/比较需要者占48.2%(109/226)。在需求内容上,不同工作状态者对"药品说明书解读"服务的需求率比较,差异有统计学意义(P<0.05);不同家庭人均月收入者对"用法用量及疗程"服务的需求率比较,差异有统计学意义(P<0.05)。在需求来源上,不同年龄、工作状态、残疾等级者对由医生提供药学服务的需求率比较,差异有统计学意义(P<0.05);不同年龄者对通过媒体获得药学服务的需求率比较,差异有统计学意义(P<0.05)。在需求程度上,不同文化程度、工作状态、残疾类别、残疾等级者对药学服务的需求程度比较,差异有统计学意义(P<0.05)。结论不同情况残疾人的药学服务需求内容差异性不大,但需求来源、需求程度差异性较大,尤其是需求程度。社区药师应采用多种形式对残疾人开展用药宣教和个性化药学服务。
Background People with disabilities are very susceptible to many diseases.Most of available studies have discussed medical services needs in this group,such as regular check-up,home-based care,and rehabilitation guidance,but relatively few have explored their pharmaceutical service needs.Objective To explore the needs of pharmaceutical services in community-dwelling people with disabilities,and analyze the differences in this group by basic demographic characteristics,socio-economic status,type and severity of disability.Methods From November to December 2017,a survey was conducted in a simple random sample of 230 registered people with disabilities from a street of Shanghai.A self-designed questionnaire was used in the survey to collect the following data:basic demographic characteristics(gender,age,marital status),socioeconomic status(educational level,retired or not,household monthly income per capita),type and severity of disability,pharmacy services(components and grade of pharmacy service needs,and providers satisfying such needs).Results Altogether,226 cases(98.3%) responded effectively to the survey.The top two demands were "usage and dosage"(73.0%,165/226) and "indications and contraindications"(51.3%,116/226).The rate of demanding "interpretation of drug package inserts" service differed significantly by the prevalence of retirement(P<0.05).And the rate of needing services of interpreting "usage,dosage and course of treatment" varied significantly by household monthly income per capita(P<0.05).The main provider satisfying pharmaceutical service demand was "doctor"(85.4%,193/226).The rate of needing a doctor to satisfy such demands changed obviously by age,prevalence of retirement,and severity of disability(P<0.05).The rate of satisfying such demands through social media varied significantly by age(P<0.05).Pharmacy services were highly/relatively demanded in 48.2%(109/226)of the respondents.The grade of demanding of such services differed significantly by educational level,prevalence of retirement,type and severity of disability(P<0.05).Conclusion Community-dwelling people with disabilities with different characteristics showed great differences in providers in demand for satisfying needed pharmaceutical services,and even greater differences in the grade of pharmaceutical services in demand,but showed similar components of such services in demand.So community pharmacists should deliver targeted medication education and pharmaceutical services in accordance with personal conditions.
Background People with disabilities are very susceptible to many diseases.Most of available studies have discussed medical services needs in this group,such as regular check-up,home-based care,and rehabilitation guidance,but relatively few have explored their pharmaceutical service needs.Objective To explore the needs of pharmaceutical services in community-dwelling people with disabilities,and analyze the differences in this group by basic demographic characteristics,socio-economic status,type and severity of disability.Methods From November to December 2017,a survey was conducted in a simple random sample of 230 registered people with disabilities from a street of Shanghai.A self-designed questionnaire was used in the survey to collect the following data:basic demographic characteristics(gender,age,marital status),socioeconomic status(educational level,retired or not,household monthly income per capita),type and severity of disability,pharmacy services(components and grade of pharmacy service needs,and providers satisfying such needs).Results Altogether,226 cases(98.3%) responded effectively to the survey.The top two demands were "usage and dosage"(73.0%,165/226) and "indications and contraindications"(51.3%,116/226).The rate of demanding "interpretation of drug package inserts" service differed significantly by the prevalence of retirement(P<0.05).And the rate of needing services of interpreting "usage,dosage and course of treatment" varied significantly by household monthly income per capita(P<0.05).The main provider satisfying pharmaceutical service demand was "doctor"(85.4%,193/226).The rate of needing a doctor to satisfy such demands changed obviously by age,prevalence of retirement,and severity of disability(P<0.05).The rate of satisfying such demands through social media varied significantly by age(P<0.05).Pharmacy services were highly/relatively demanded in 48.2%(109/226)of the respondents.The grade of demanding of such services differed significantly by educational level,prevalence of retirement,type and severity of disability(P<0.05).Conclusion Community-dwelling people with disabilities with different characteristics showed great differences in providers in demand for satisfying needed pharmaceutical services,and even greater differences in the grade of pharmaceutical services in demand,but showed similar components of such services in demand.So community pharmacists should deliver targeted medication education and pharmaceutical services in accordance with personal conditions.
引文
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[7]单海燕,刘骜,何旖旎,等.老年人合理用药及安全性[J].中国全科医学,2015,18(35):4362-4364.DOI:10.3969/j.issn.1007-9572.2015.35.022.SHAN H Y,LIU A,HE Y N,et al.Rational drug use and safety of the elderly[J].Chinese General Practice,2015,18(35):4362-4364.DOI:10.3969/j.issn.1007-9572.2015.35.022.
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[9]田海燕,刘娅,杨艳,等.高血压患者高血压防治知识与健康行为现状及影响因素研究[J].现代预防医学,2016,43(24):4481-4484.TIAN H Y,LIU Y,YANG Y,et al.Study on the status and influencing factors of awareness of hypertension prevention and health behavior among the patients with hypertension[J].Modern Preventive Medicine,2016,43(24):4481-4484.
[10]刘彩,何强,王薇.天津市居民服药依从性现状及影响因素分析[J].中国卫生事业管理,2016,33(1):42-45.LIU C,HE Q,WANG W.Analyzing the status of residents'medication compliance and its influencing factors in Tianjin[J].Chinese Health Service Management,2016,33(1):42-45.
[11]刘宁,武琼,陈敏.个性化医疗服务类型及相关数据资源研究[J].中国卫生信息管理杂志,2016,13(1):93-98.LIU N,WU Q,CHEN M.Service types and data resources research on personalized medicine[J].Chinese Journal of Health Informatics and Management,2016,13(1):93-98.
[12]张彦琦,张玲,易东,等.重庆市高血压和糖尿病患者社区健康管理现状及影响因素研究[J].中国全科医学,2015,18(28):3473-3476.DOI:10.3969/j.issn.1007-9572.2015.28.021.ZHANG Y Q,ZHANG L,YI D,et al.Status of and influencing factors for the community health management of hypertensive and diabetic patients in Chongqing[J].Chinese General Practice,2015,18(28):3473-3476.DOI:10.3969/j.issn.1007-9572.2015.28.021.
[13]陈蓉,游一中,邵志高,等.英格兰社区药师的药学服务及对国内药师参与慢病管理的启示[J].中国医院药学杂志,2015,35(17):1612-1615.DOI:10.13286/j.cnki.chinhosppharmacyj.2015.17.22.CHEN R,YOU Y Z,SHAO Z G,et al.Enlightenment from community pharmacy services in England for domestic pharmacists to manage chronic diseases[J].Chinese Journal Hospital Pharmacy,2015,35(17):1612-1615.DOI:10.13286/j.cnki.chinhosppharmacyj.2015.17.22.
[14]刘琴,曹凤,王乐.新疆乌鲁木齐市听力残疾人群对健康管理服务认知和需求的现状调查[J].新疆医学,2016,46(7):822-856.LIU Q,CAO F,WANG L.Situation survey of awareness and demand of healthy management for hearing disabled people in Urumqi[J].Xinjiang Medical Journal,2016,46(7):822-856.2018091120190412
[2]鲁珺,吴跃传,王超.北京某大型社区居民药学服务需求调查与分析[J].药品评价,2012,9(20):18-22.LU J,WU Y C,WANG C.Investigation and analysis of the demand for pharmaceutical services among the residents of a large community in Beijing[J].Drug Evaluation,2012,9(20):18-22.
[3]风笑天.社会学研究方法[M].北京:中国人民大学出版社,2001:145-149.
[4]陈晔,林俊榜,张晓丹,等.社区药学服务调查报告Ⅱ[J].中国现代应用药学,2015,32(2):220-224.DOI:10.13748/j.cnki.issn1007-7693.2015.02.025.CHEN Y,LIN J B,ZHANG X D,et al.Investigation report of community pharmaceutical serviceⅡ[J].Chinese Journal of Modern Applied Pharmacy,2015,32(2):220-224.DOI:10.13748/j.cnki.issn1007-7693.2015.02.025.
[5]孙建勋,周秋霞,岳淑梅.我国老年群体慢性病患病状况及药学服务需求调查[J].中国药学杂志,2016,51(2):155-158.SUN J X,ZHOU Q X,YUE S M.Survey on the prevalence of chronic diseases and the demands of pharmaceutical care in elderly population in China[J].Chinese Pharm Aceutical Journal,2016,51(2):155-158.
[6]林秋晓,夏晨,刘秋琼,等.广州市部分社区老年人用药现状与药学服务需求调查分析[J].中国药房,2017,28(12):1591-1594.LIN Q X,XIA C,LIU Q Q,et al.Investigation and analysis of medication situation and need for pharmaceutical services of geriatric people from some communities in Guangzhou[J].China Pharmacy,2017,28(12):1591-1594.
[7]单海燕,刘骜,何旖旎,等.老年人合理用药及安全性[J].中国全科医学,2015,18(35):4362-4364.DOI:10.3969/j.issn.1007-9572.2015.35.022.SHAN H Y,LIU A,HE Y N,et al.Rational drug use and safety of the elderly[J].Chinese General Practice,2015,18(35):4362-4364.DOI:10.3969/j.issn.1007-9572.2015.35.022.
[8]徐倩,白松,冯湘君,等.老年共病与多重用药的应对策略[J].中国全科医学,2017,20(23):2823-2826.DOI:10.3969/j.issn.1007-9572.2017.23.004.XU Q,BAI S,FENG X J,et al.Countermeasures for polypharmacy in the elderly with comorbidity[J].Chinese General Practice,2017,20(23):2823-2826.DOI:10.3969/j.issn.1007-9572.2017.23.004.
[9]田海燕,刘娅,杨艳,等.高血压患者高血压防治知识与健康行为现状及影响因素研究[J].现代预防医学,2016,43(24):4481-4484.TIAN H Y,LIU Y,YANG Y,et al.Study on the status and influencing factors of awareness of hypertension prevention and health behavior among the patients with hypertension[J].Modern Preventive Medicine,2016,43(24):4481-4484.
[10]刘彩,何强,王薇.天津市居民服药依从性现状及影响因素分析[J].中国卫生事业管理,2016,33(1):42-45.LIU C,HE Q,WANG W.Analyzing the status of residents'medication compliance and its influencing factors in Tianjin[J].Chinese Health Service Management,2016,33(1):42-45.
[11]刘宁,武琼,陈敏.个性化医疗服务类型及相关数据资源研究[J].中国卫生信息管理杂志,2016,13(1):93-98.LIU N,WU Q,CHEN M.Service types and data resources research on personalized medicine[J].Chinese Journal of Health Informatics and Management,2016,13(1):93-98.
[12]张彦琦,张玲,易东,等.重庆市高血压和糖尿病患者社区健康管理现状及影响因素研究[J].中国全科医学,2015,18(28):3473-3476.DOI:10.3969/j.issn.1007-9572.2015.28.021.ZHANG Y Q,ZHANG L,YI D,et al.Status of and influencing factors for the community health management of hypertensive and diabetic patients in Chongqing[J].Chinese General Practice,2015,18(28):3473-3476.DOI:10.3969/j.issn.1007-9572.2015.28.021.
[13]陈蓉,游一中,邵志高,等.英格兰社区药师的药学服务及对国内药师参与慢病管理的启示[J].中国医院药学杂志,2015,35(17):1612-1615.DOI:10.13286/j.cnki.chinhosppharmacyj.2015.17.22.CHEN R,YOU Y Z,SHAO Z G,et al.Enlightenment from community pharmacy services in England for domestic pharmacists to manage chronic diseases[J].Chinese Journal Hospital Pharmacy,2015,35(17):1612-1615.DOI:10.13286/j.cnki.chinhosppharmacyj.2015.17.22.
[14]刘琴,曹凤,王乐.新疆乌鲁木齐市听力残疾人群对健康管理服务认知和需求的现状调查[J].新疆医学,2016,46(7):822-856.LIU Q,CAO F,WANG L.Situation survey of awareness and demand of healthy management for hearing disabled people in Urumqi[J].Xinjiang Medical Journal,2016,46(7):822-856.2018091120190412