| Summary: | 碩士 === 國立成功大學 === 護理學系碩博士班 === 96 === There are 60 percent of elderly with two or more chronic diseases. Life long treatment is necessary for these patients to control the progress of diseases. If the elderly failed to take their medications as prescribed, their chronic conditions may be devastating and may lead to hospitalization and even life-threatening. Studies showed that perceived barriers is the most powerful predictor to medication adherence. Less attention has been given to medication adherence among the elderly with multiple chronic diseases. Therefore, the purpose of this study is to examine the barriers of medication adherence behavior among elderly patients with multiple chronic diseases.
Qualitative multi-case study was used. Purposive sampling and in-depth interviews were conducted to collect the data. Fourteen participants over aged 65 with two or more chronic diseases with life long medication treatment were recruited from the OPD in a medical center and a community hospital at southern Taiwan. Based on Chen’s Medication-taking Behavioral Model for Elderly Patients with Chronic Diseases and literature review, semi-structured interview guide was developed. Prior development of theoretical propositions and cross-case-analysis were used for data analysis.
The findings showed that the health-seeking history of participants were complex and influenced by multiple factors. Several participants were under the risk of inappropriate medication regimen. Non-adherence medication taking behaviors included: self-medication, discontinued and misusing medication (timing or dose), combining Western medications with other therapies, sharing medications, and hoarding medications. The barriers of adherence medication taking behavior can be described by five major concepts in Chen’s model except the concept of “worry about taking medication”. The meaning of each concept in original model has been extended under the context of multiple chronic diseases. Due to the complexity of the medication taking behaviors among multiple chronic diseases elderly patients, multi-disciplinary interventions were required to provide a safe and effective medication regimen.
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