| Summary: | 碩士 === 國立陽明大學 === 衛生福利研究所 === 92 === Self-medication is common in Taiwan, and the prevalence and incidence rate of dialysis patients in Taiwan ranked the second in the world, and dialysis is one of the key elements in the National Health Insurance (NHI) medical expenditure. It has been a tempting issue whether there is any relation between the two phenomena. However, there is only limited study available on patients’ self-medication behavior prior to dialysis.
This study aimed to investigate the self-medication behavior of dialysis patients before dialyses and to find out its influencing factors.Structural questionnaire investigation method was used in this study. We randomly selected 1885 samples that are 25% of ESRD patients who received identification card of serious diseases in 2001. By mailing questionnaires to each study subject, we obtained 438 valid questionnaires representing 23% of total samples. These valid questionnaires collected were then analyzed by using statistical techniques with SPSS10.0.
There were 267 patients (61.0%) responded having self-medication one year prior to dialysis, while 171 patients (39.0%) responded not having self-medication the same period before dialysis. Among the 267 patients having self-medication, there were 142 patients (53.0%) who have taken non-prescription medicines, 101 patients (37.8%) have taken health foods and 179 patients (67.0%) have taken Chinese medicines. From the multiple logistic regression analyses, several factors influencing self-medication behavior were identified: Patients with older age, high level of education, native religion belief, tendency toward not seeing to a doctor, low satisfaction with doctor visit and have internal controlled personality tend to self-medicate by themselves. Patients with older age, dislike seeing a doctor, dissatisfy with doctor visits, feel healthy, suffer from chronic diseases and have powerful others controlled personality tend to take non-prescription medicines by themselves. Patients with high income, live in the low-urbanized city, obtain the messages about healthy food from the mass media, do not suffer from chronic diseases and have powerful others controlled personality tend to take health foods by themselves. Patients who are aware of inconvenience in visiting a doctor, dissatisfy with the high cost on the medical treatment and obtain the messages about Chinese medicine from the mass media tend to take Chinese medicine by themselves. In addition, patients who are aware of inconvenience in visiting a doctor, live in the high-urbanized city and have powerful others controlled personality are classified as group of high intensity self-medication.
This study suggests that governments should cultivate people to have correct concepts of self-medication and to change their misconceived behaviors of taking medicines, enhance and fully develop community pharmacies and increase communication between doctors and patients. In the future, some topics such as the enrollment system of serious diseases in NHI, the follow-up survey of patients with renal disease, and the qualitative study of self-medication may be worthwhile for further studies.
Keyword: dialysis patients, self-medication, retrospective study
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