目的 了解儿童服药困难问题现状并分析其影响因素,为制定提高儿童服药依从性具体措施提供依据。方法 对2018年1—4月在北部战区总医院就诊的600例年龄介于6个月~12周岁患儿家长进行问卷调查。调查结果分为服药困难组和非服药困难组,针对个人和家庭因素及不同干预措施进行统计学分析,对有统计差异的因素进行Logistic回归分析,明确影响因素并提出针对性预防措施。结果 共回收558例有效问卷,儿童总体服药困难377例(67.6%),6月~<1岁,1~<3岁,3~<6岁,6~<12岁儿童服药困难发生率分别为83.8%,68.0%,67.2%和53.8%。单因素分析结果提示儿童年龄、父母受教育程度、职业及干预措施4项因素差异有统计学意义(P＜0.05)。多因素Logistic回归分析结果显示儿童服药困难的独立危险因素有儿童年龄、父母职业,采取干预措施为保护因素(P＜0.05)。结论 儿童服药困难发生率较高,本研究显示儿童服药困难的发生与儿童年龄、父母职业及干预措施有关。
Abstract
Objective To know about the current status and influencing factors of difficulty in taking medicine for children,in order to provide evidence for improving medicine compliance of children. Methods A questionnaire survey was conducted in 600 children aged 6 months to 12 years in Northern Theater Command General Hospital from January to April 2018.Children were divided into difficulty in taking medicine group and without difficulty in taking medicine group according to the investigation Results.Statistical analysis was conducted on individual and family influencing factors and different intervention measures,then Logistic regression analysis was conducted on the meaningful factors. Results Totally 558 valid questionnaires were collected.Among 558 children,377(67.6%) children suffered from difficulty in taking medicine.And the rates of difficulty in taking medicine in children aged 6 months to 1 year,1 to 3 years,3 to 6 years and 6 to 12 years were 83.8%,68.0%,67.2% and 53.8%,respectively.Single factor analysis revealed that children′s age,parents′ education,occupation and intervention measures was significant factors for difficulty in taking medicine(P<0.05).Multivariate Logistic analysis showed that the children′s age,parents′ education were risk factors for difficulty in taking medicine,while taking intervention measures was a protective factor(P<0.05). Conclusion Difficulty in taking medicine is prevalent,and it is associated with children′s age,parents′ education and intervention measures.
关键词
服药困难 /
调查分析 /
儿童
Key words
difficulty in taking medicine /
investigation /
children
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] 王春婷,李玉基,夏冬胜,等.儿童用药现状及对策[J].中国药物警戒,2013,10(8):492-496.
[2] Cherry DK,Woodwell DA,Rechtsteiner EA.National ambulatory medical care survey:2005 summary[J].Adv Data,2007,29(387):1-39.
[3] 陈倩,杜光.儿科药物剂型现状及管理策略[J].儿科药学杂志,2013,19(8):49-52.
[4] 韦春燕,李发标.我院儿科用药现状调查[J].临床合理用药杂志,2016,9(16):102-103.
[5] Jones DF,McRea AR,Jairath MK,et al.Prospective assessment of pill- swallowing ability in pediatric patients[J].Clin Pediatr(Phila),2018,57(3):300-306.
[6] Chang YT,Lee LL.The effectiveness of compliance therapy on drug attitude among schizophrenic patients:a systematic review[J].JBI Database System Rev Implement Rep,2015,13(7):213-240.
[7] Llorca PM.Discussion of prevalence and management of discomfort when swallowing pills:orodispersible tablets expand treatment options in patients with depression[J].Ther Deliv,2011,2(5):611-622.
[8] Nunn T,Williams J.Formulation of medicines for children[J].Br J Clin Pharmacol,2005,59(6):674-676.
[9] Spomer N,Klingmann V,Stoltenberg I,et al.Acceptance of uncoated mini-tablets in young children:results from a prospective exploratory cross-over study[J].Arch Dis Child,2012,97(3):283-286.
[10] Walsh J,Bickmann D,Breitkreutz J,et al.Delivery devices for the administration of pediatric formulations:overview of current practice,challenges and recent developments[J].Int J Pharm,2011,415(1-2):221-231.
[11] Cohen R,de La Rocque F,Lecuyer A,et al.Study of the acceptability of antibiotic syrups,suspensions,and oral solutions prescribed to pediatric outpatients[J].Eur J Pediatr,2009,168(7):851-857.
[12] Mattingly GW,Wilson J,Rostain AL.A clinician′s guide to ADHD treatment options[J].Postgrad Med,2017,129(7):657-666.
[13] Gaskell C.Use of pill glide to encourage transition from liquid to solid dosage formulation[J].Arch Dis Child,2016,101(9):e2-e3.
[14] 刘恩梅,陆权.规范儿童用药,保障儿童健康[J].儿童用药杂志,2016,22(3):1005-1007.
[15] Thomson SA,Tuleu C,Wong IC,et al.Minitablets:new m odality to deliver medicines to preschool-aged children[J].Pediatrics,2009,123(2):e235-e238.
[16] Van de Vijver E,Desager K,Mulberg AE,et al.Treatment of infants and toddlers with cystic fibrosis-related pancreatic insufficiency and fat malabsorption with pancrelipase MT[J].J Pediatr Gastroenterol Nutr,2011,53(1):61-64.
[17] van Riet-Nales DA,de Neef BJ,Schobben AF,et al.Acceptability of different oral formulations in infants and preschool children[J].Arch Dis Child,2013,98(9):725-731.
[18] Mennella JA,Beauchamp GK.Optimizing oral medications for children[J].Clin Ther,2008,30(11):2120-2132.
[19] Adar L,Zarycranski W,Conner JB,et al.Bioequivalence of cyclobenzaprine hydrochloride extended-release capsule taken intact or sprinkled over applesauce[J].JBI Database System Rev Implement Rep,2015,13(7):213-240.
[20] 张楠,王爱敏,于桂玲,等.子女教育心理控制源对哮喘儿童用药依从性的影响[J].中国儿童保健杂志,2015,23(1):18-20.
[21] Patel A,Jacobsen L,Jhaveri R,et al.Effectiveness of pediatric pill swallowing interventions:a systematic review[J].Pediatrics,2015,135(5):883-889.
PDF(612 KB)
