目的 研究哮喘儿童用药依从性与子女教育心理控制源的关系,分析用药依从性的影响因素,以采取相应对策,更好的提高治疗依从性。方法 2013年9月-2013年12月期间于某院门诊就诊的6~11岁儿童209名,根据自行编制的哮喘儿童用药依从性家长问卷分为依从组、非依从组,用t检验、秩和检验和χ²检验分析用药依从性与子女教育心理控制源各因子、年龄、性别、病程、认知、吸入技术等的关系,进一步用二分类Logistic回归分析影响用药依从性的主要因素。结果 单因素分析显示,年龄、病程、家庭收入、主要照顾者文化程度、父母认知、吸入技术掌握情况、峰流速仪的使用、担心副作用、发作次数、急诊次数和子女教育心理控制源5个因子在内的15个指标,两组间差异具有统计学意义(P<0.01)。二分类Logistic回归分析显示,父母认知、子女对父母生活的控制、父母对子女行为的控制是进入回归方程的因素(P<0.05)。结论 父母对哮喘认知的水平和对患儿行为的管理对提高用药依从性有十分重要的作用,应加强哮喘儿童家庭的心理社会支持,采取更有效的父母管理策略和方法。

Objective To study parenting locus of control and the medication adherence,to investigate the factors affecting medication adherence in children with asthma,and to provide basis for intervention measure for improve the adherence of medication. Methods A total of 209 children with asthma were enrolled from September 2013 to December 2013 and were divided into 2 groups with Morisky Medication Adherence Scale:nonadherence group and adherence group.Univariate and binary regression analysis were used to compare the differences of 19 indicators including Parenting Locus of Control Scale (PLOC) and ages,the mastery of inhalation technique and so on between the two group to find out the main factors influencing the medication adherence. Results According to the univariate analysis,the age,course of the disease,income of the family,education level of the main caregivers,the parents knowledge,the mastery of inhalation technique,the use of peak flow meter,worry about the side effect,onset times,emergency times and PLOC were different between the two groups(P<0.01).The binary regression analysis showed that the parents knowledge,factor 3 and 5 of PLOC were the main factors which influenced the medication adherence(P<0.01). Conclusions The knowledge of the parents and the management of children are important for improving the medication adherence.The asthma children's family psychological and social support should be strengthened,and more effective management strategies and method were taken.