新医改背景下公众用药教育模式研究

发布时间：2018-02-15 19:15

本文关键词： 用药教育调查研究公众药师教育模式　出处：《广东药学院》2014年硕士论文　论文类型：学位论文

【摘要】：目的：用药教育起源于国外19世纪中后期，它作为药学服务的重要一环在国外已经得到较为完善得发展。而我国在90年代才开始全国范围内开展，到目前为止，我国依旧停留在用药教育的起步阶段。因此本课题通过系统规范的调查研究，以广东省为主体（华南）结合黑龙江（东北）、河南（中部）、浙江（华东）和贵州（西南地区）另外四省公众以及广东省医院药房和药店药师为调查对象，全面系统地了解用药教育的普及程度和公众对用药教育的认知度以及用药教育在实施过程中的障碍和困难，并对调研结果进行统计分析，根据结果初步构建出适合我国的用药教育模式。方法：查阅文献发现国内外有关用药教育的调查范围基本都是在医院或是某个社区，调查对象则是患者或者社区居民，范围比较窄。而本次调查研究不仅是患者，还包括普通公众和药师，，调查范围则涉及到五个省份。本次调研于2013年1月-2013年7月之间进行，采用自制调查问卷，由经过筛选与培训、具有药学知识背景的调查员到各地区进行现场调查，以不记名方式填写，填写完毕后当场收回。对回收的问卷进行仔细检查，剔除无效问卷。采用Excel2003输入数据并做初步处理，采用统计软件SPSSl9.0进行统计分析。结果：本次调研样本发放量大，涵盖范围较广。公众问卷部分：广东省内共发放问卷3250份，回收3184份，无效问卷325份，有效回收率为87.97%；另外四省共发放问卷1620份，回收1601份，无效问卷136份，有效回收率为90.43%。知道用药教育的公众均不超过10%，另外四省公众的知晓率高于广东省内公众；省内和省外公众参加过部分除了用药教育的实施主体无统计学差异外，其他题项均有显著性差异（P0.05）；省内和省外未参加公众部分则所有题项均具有显著性差异（P0.05）；省内和省外公众在必填题项部分差异都非常大（P0.0001）。药师问卷部分：广东省内共发放药师问卷680份，回收673份，无效问卷131份问卷，有效回收率为79.71%。用药教育内容的量表评分为4.22，表明药师对量表里的内容都比较认同；所有题项得分的标准差均小于1，说明药师对选择哪些作为用药教育内容的差异比较小；对实施用药教育的意义、障碍和困难，医院和药店药师无统计学差异（P0.05）。结论：用药教育普及程度低，公众对“用药教育”知晓度和接受率低，接受用药教育意识薄弱，并且大多数公众表示更愿意接受医护人员提供的用药教育，对药师的信任度低。建立药历和定期随访患者是用药教育中最重要的环节，而药师则对这两项支持率普遍较低。所以政府应当尽快出台相关政策法规，推进用药教育的实施，同时加强用药教育的宣传，提高公众用药教育的认知度和接受度；药师应提高自身综合业务能力，加强医学药学知识的学习，同时也应重视与公众的沟通技巧；高校也应转变药学教育模式，提高药学学生实践能力。根据本次调研结果以及在研究过程中结合公众、药师及药学相关专家的意见，共构建了三种不同的用药教育模式，为我国用药教育顺利实施提供相关参考。
[Abstract]:Objective: medication education originated abroad in late nineteenth Century, it as an important part of pharmaceutical services in foreign countries has been relatively perfect development. China began in 90s nationwide, up to now, our country is still in the initial stage. Therefore the issue of medication education through the investigation and study of the system specification as the main body, in Guangdong province (Southern China) with Heilongjiang (northeast), Henan (central), Zhejiang (East) and Guizhou (southwest) in four provinces and Guangdong province public hospital pharmacy and pharmacist for the survey, a comprehensive and systematic understanding of barriers to medication education popularity and public awareness of medication and education medication education in the implementation process and difficulties, and the research results of statistical analysis, constructs a suitable for China's drug education model according to the results.
Methods: the literature found about medication education at home and abroad survey are basically in a hospital or a community, the survey is the patients and community residents, the relatively narrow scope. And this research is not only the patient, also includes the general public and the pharmacist, survey scope will involve five provinces. The research was conducted between January 2013 -2013 July, using self-made questionnaire, by screening and training with pharmacy investigators into various regions to conduct on-site survey, fill in anonymous way, after completing the spot recovery. Careful examination of the returned questionnaires, excluding invalid input data and using Excel2003 questionnaire. Do the preliminary treatment, using statistical software SPSSl9.0 for statistical analysis.
Results: the survey sample distribution amount is large, covers a wide range. The public part of the questionnaire: Guangdong Province, a total of 3250 questionnaires, 3184 were recovered, 325 invalid questionnaires, the effective recovery rate was 87.97%; in four, a total of 1620 questionnaires, 1601 were recovered, 136 invalid questionnaires, the effective recovery rate 90.43%. know the education of medication for the public are not more than 10%, the other four provincial public awareness rate is higher than that of Guangdong province outside the province and the public; the public participated in the implementation of the main part in the education of medication have no significant difference, the other items had significant difference (P0.05); the province and the province did not participate in the public part of all items there were significant differences (P0.05); outside the province and the public in the required items are part of the difference is very large (P0.0001).
Pharmacist: part of the questionnaire in Guangdong Province issued a total of 680 questionnaires of pharmacists, recovery of 673, invalid questionnaires 131 questionnaires, the effective recovery rate was 79.71%. medication education content scale score was 4.22, showed that the content of pharmacists on scale are identity; all items score standard deviation was less than 1, the pharmacist to choose what is the difference between the content of medication education is relatively small; the implementation of medication education significance, obstacles and difficulties, no significant difference between hospitals and pharmacies pharmacists (P0.05).
Conclusion: medication education penetration is low, the public on the "drug education" awareness and acceptance rate is low, accept medication education consciousness is weak, and the majority of the public expressed a willingness to accept the education of medication for medical personnel to provide the low trust of pharmacists. Establish a medication and regular follow-up of patients is the most important part in the education of medication the pharmacist is, on the two support rate is generally low. So the government should as soon as possible to promote the implementation of policies and regulations, and strengthen the education of medication, medication education propaganda, raise awareness of the public administration education and acceptance; pharmacists should improve their comprehensive professional ability, strengthen medical and pharmaceutical knowledge, at the same time the public should pay attention to and communication skills; colleges should also change pharmaceutical education, improve pharmacy students practical ability. According to the research results, combined with the public in the process of research, The opinions of pharmacists and pharmaceutical experts have constructed three different modes of medication education to provide reference for the successful implementation of drug education in China.

【学位授予单位】：广东药学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R95

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