| Background and ObjectiveWith the rapid development of global economy and society,the problem of ageing is becoming more serious today.As the largest developing country,China has also experienced a rapid aging process due to the great population base,and it is expected to reach the "peak of the old age" during the period of 2041-2064.At the same time,chronic disease such as cardiovascular disease,diabetes,cancer,chronic obstructive pulmonary disease has become a great threat to the health of our residents,and the elderly people become the main group of chronic disease due to their degenerative changes in body function,increased susceptibility to diseases,and long-term exposure to pathogenic factors of environment.However,the control effect of elderly patients with chronic diseases is always suboptimal,and the poor medication adherence is one of the most important reasons.At the same time,although the chronic disease management has been the focus of our health work in China,there also exist many problems that put adverse effects on the control effect of chronic disease.Therefore,comprehensively understanding the current situation and influencing factors of the medication use behavior of Chinese elderly patients with chronic diseases is of great significance for improving their medication adherence,improving the effect of disease control and ameliorating the quality of life.Based on the deep comprehension about demographic characteristics,physical health,mental health and lifestyle condition of elderly patients with chronic diseases,the study tries to reveal the factors which have important effects on the medication adherence,so as to provide evidences and suggestions for taking targeted measures to make some improvements.It can not only identify those notable influencing factors,but also could make our understanding of those effects increase from empirical level to qualitative level,so as to provide a solid theoretical foundation for improvement.Moreover,chronic disease has been recognized as the main reason that puts negative impact on their health and quality of life of the elderly,so it is also of great significance in promoting the process of healthy aging in our country by improving the medication adherence and enhancing its control effect.Material and MethodsData in this study was from the database of the National Natural Science Fund(71673169),which made use of the method of multi-stage random sampling to conduct questionnaire survey on all the extracted residents over 60 years old,and a total of 4788 persons with chronic diseases(hypertension,diabetes,coronary heart disease chronic obstructive pulmonary disease,and cancer)were finally selected as the research objects.The information about demographic characteristics,physical health status,life style was collected by self-made questionnaires.The scales of Kessler 10 and Morisky were used to evaluate the psychological health and medication adherence,which have both good reliability and validity.Descriptive statistics,one sample t-test,non-parametric test,variance analysis and multiple linear regression were performed by SPSS 20.0.Structural Equation Model was performed by Amos 17.0 to analyze the combined relationship among physical health,psychological health,life style and medication adherence.ResultsThe average score of Morisky scale for elderly patients with chronic diseases in Shandong was 1.40 + 1.38,and the proportion of good medication adherence was 38.91%,the middle level was 34.5%,and the bad level was 26.6%.The multiple regression analysis about demographic characteristics showed that age,income and self-evaluated economic conditions all had notable effects on Morisky scores of elderly patients,so with the increase of age,income and improved self-estimated economic situation,the patients tended to have better medication adherence.The structural equation model showed that there were significant positive correlations among physical health,psychological health and life style.The coefficient between life style and physical health was 0.48,and it was 0.30 between psychological health and life style,as well as 0.59 between physical health and psychological health.The standardized path coefficient of life style behavior→medication adherence was 0.16,that of psychological health→medication adherence was 0.19,indicating that the elderly patients with unhealthy life style and poor psychological health tended to have medication non-adherence.The standardized path coefficient of physical health→medication adherence was-0.15,suggesting that the elderly patients with worse physical health condition tended to have better medication adherence.ConclusionsThe medication adherence of elderly patients with chronic disease in Shandong was poor,influencing demographic factors include age,annual income and self-evaluated economic situation.Physical health,psychological health and life style interacted with each other,all of which had significant impacts on elderly patients’ behavior of medication use,and psychological health condition was the most important factor.SuggestionsIncreasing the elderly patients’ income is the foundation of improving theirmedication adherence.Reducing the medical burden is an important guarantee to improve their medication adherence.Psychological health intervention is also a key to improvement of their medication adherence.Changing the unhealthy life style is crucial for enhancing their medication adherence. |
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