社團法人臺灣臨床藥學會

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【原著】服藥遵從行為中文量表之信、效度測量
The Reliability and Validity of the Chinese Version of the Medication Adherence Scale
高血壓、服藥遵從行為、信度、效度、Hypertension, Adherence, Reliability, Validity
何振珮Chen-Pei Ho1.2 、李哲夫Tony Jer-Fu Lee1.2.3.4.5.
1花蓮慈濟綜合醫院藥劑部 、2慈濟大學醫學科學研究所 、3花蓮慈濟綜合醫院研究部
研究目的在建構適合臺灣高血壓病人使用之服藥遵從行為中文量表。花蓮某醫院546 位門診高血壓病人為研究對象進行橫斷研究(cross-sectional study),使用結構式問卷與實測血壓進行調查。研究使用SPSS 20.0統計軟體進行資料分析,Cronbach’s α 用於評估量表內部一致性信度,皮爾森積差相關、史比爾曼等級相關分析用於評估量表同時效度,因素分析用於評估量表建構效度。量表平均分數為1.7,遵從行為佳者佔70.1%,遵從行為不佳者佔29.9%。量表信度Cronbach’s α = 0.70 (95% CI = 0.6 ~ 0.73),因素分析量測可解釋變異量為46%,八題因素負荷量均> 0.3。遵從行為與態度(r = 0.35, p = 0 .00)、主觀規範(r = 0.19, p = 0 .00)、自覺行為控制(r = 0.49, p = 0 .00)、意圖(r = 0.33, p = 0 .00) 呈顯著正相關;遵從行為與舒張壓(r = 0.13, p = 0 .00)、平均動脈壓(r = 0.11, p = 0 .01) 呈顯著正相關,遵從行為與收縮壓則無顯著正相關(r = 0.07, p = 0.13);但是當分別考慮收縮壓與舒張壓時,兩組遵從行為與收縮壓(r = 0.11, p = 0 .01)、舒張壓(r = 0.09, p = 0 .04) 控制優劣呈顯著正相關。總結研究發現,服藥遵從行為中文量表具有良好信、效度,並能精準測量出臺灣高血壓病人服藥遵從行為。
 
The aim of the study was to construct the Chinese version of the Medication Adherence Scale among Taiwanese patients with hypertension. Five hundred and forty-six outpatients with established chronic hypertension at a regional hospital in Hualien were enrolled. Using a cross-sectional study, BP was measured and structured questionnaires were answered by all participants. Internal consistency was assessed using Cronbach’s α coefficient, concurrent validity using correlation analysis, and construct validity using factor analyses. All data were analyzed using SPSS 20.0 statistical analysis software. The mean of the scale scores was 1.7. Adherence and poor adherence of patients accounted for 70.1% and 29.9%, respectively. Cronbach’s α was found to be 0.70 (0.66 ~ 0.73) with 95% CI. Factor analyses was found R2 (46%), and all factor loadings of the scale was > 0.3. Adherence was positively correlated with attitude (r = 0.35, p = 0 .00), subjective norm (r= 0.19, p = 0 .00)、perceived behavior control (r = 0.49, p = 0 .00) and intention (r = 0.33, p = 0 .00). Adherence was positively correlated with the DBP (r = 0.13, p = 0 .00), MAP (r = 0.11, p = 0 .01) and the SBP (r = 0.07, p = 0.13). But, when SBP and DBP were considered separately, adherence was significantly different between good and poor controls of SBP and DBP. The two groups were positively correlated with SBP control (r = 0.11,p = 0 .01) and DBP control (r = 0.09, p = 0.04). In summary, the Chinese version of the Medication Adherence Scale is a reliable and valid measure of medication adherence in Taiwanese patients with hypertension.
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