/
1هرود ،ﻪﺘﻓﺎﯾ 23
، رﺎﻬﺑ 1400
:ﻪﺒﺗﺎﮑﻣ سردآ*
ﯽﺳﺎﻨﺸﻧاور هوﺮﮔ ،ﯽﻣﻼﺳا دازآ هﺎﮕﺸﻧاد ،دﺎﺑآ ﻒﺠﻧ .
ﺖﺴﭘ :ﮏﯿﻧوﺮﺘﮑﻟا [email protected]
ﻌﺒﺗ ﯿ ﺖ وراد نﺎﻣرد زا ﯽﯾ
رد نارﺎﻤﯿﺑ د
ﯾ ﺘﺑﺎ ﯽ عﻮﻧ 2 و نآ ﺎﺑ ﻂﺒﺗﺮﻣ ﻞﻣاﻮﻋ
هداز يرﺪﺑ ﻪﻧﺎﺴﻓا ، 1
ﯽﯾﻮﻟﺎﻤﺟ ﯽﯾﺎﺿر ﻦﺴﺣ
2
، *
هداﺰﻧﺎﺧ ﯽﻔﻄﺼﻣ ﺪﯿﻌﺳ ، 3
ﻓ ﯽﻏوﺮ
، 4
ﯽﮐﺎﺳ ﺎﻧاﺪﻧﺎﻣ
5
1 - د يﻮﺠﺸﻧاد آ ﻒﺠﻧ ﺪﺣاو ،ﺖﻣﻼﺳ ﯽﺳﺎﻨﺸﻧاور يﺮﺘﮐ
ﮕﺸﻧاد ،دﺎﺑ ناﺮﯾا ،دﺎﺑآ ﻒﺠﻧ ،ﯽﻣﻼﺳا دازآ هﺎ
2 - رﺎﯾدﺎﺘﺳا ناﺮﯾا ،دﺎﺑآ ﻒﺠﻧ ،ﯽﻣﻼﺳا دازآ هﺎﮕﺸﻧاد ،دﺎﺑآ ﻒﺠﻧ ﺪﺣاو ،ﯽﺳﺎﻨﺸﻧاور هوﺮﮔ ،
3 -
،رﺎﯾدﺎﺘﺳا هوﺮﮔ
،ﯽﺳﺎﻨﺸﻧاور ﻪﺴﺳﺆﻣ
شزﻮﻣآ ﯽﻟﺎﻋ ﯽﺘﻟودﺮﯿﻏ ﯽﻋﺎﻔﺘﻧاﺮﯿﻏ- ﺾﯿﻓ
،مﻼﺳﻻا ﯽﻨﯿﻤﺧ
،ﺮﻬﺷ
،نﺎﻬﻔﺻا ناﺮﯾا
4 -
،رﺎﯾدﺎﺘﺳا
،يرﺎﺘﺳﺮﭘ هوﺮﮔ
،زردﻮﮑﯿﻟا يرﺎﺘﺳﺮﭘ هﺪﮑﺸﻧاد
،نﺎﺘﺳﺮﻟ ﯽﮑﺷﺰﭘ مﻮﻠﻋ هﺎﮕﺸﻧاد
،زردﻮﮕﯿﻟا ناﺮﯾا
5 - ﯿﻘﺤﺗ ﺰﮐﺮﻣ ،رﺎﯾدﺎﺘﺳا ﺖﻣﻼﺳ ﺮﺑ ﺮﺛﻮﻣ ﯽﻋﺎﻤﺘﺟا ﻞﻣاﻮﻋ تﺎﻘ
، ﻮﻠﻋ هﺎﮕﺸﻧاد ،دﺎﺑآ مﺮﺧ ،نﺎﺘﺳﺮﻟ ﯽﮑﺷﺰﭘ م
ناﺮﯾا
هرود / ﻪﺘﻓﺎﯾ 23
هرﺎﻤﺷ / 2
/ رﺎﻬﺑ 1400 / ﻞﺴﻠﺴﻣ 87
:ﻪﻟﺎﻘﻣ ﺖﻓﺎﯾرد 05
/ 07 / 99 ﻟﺎﻘﻣ شﺮﯾﺬﭘ :ﻪ
26 / 09 / 99
ﻪﻣﺪﻘﻣ :
زا ﺖـﯿﻌﺒﺗ .ﺖـﺳا ﻢـﻬﻣ رﺎﯿﺴﺑ نآ رد نﺎﻣرد ﻪﺑ يﺪﻨﺒﯾﺎﭘ و ﺖﺳا ﺖﺑﺎﯾد نﺎﻬﺟ ﺮﺳاﺮﺳ رد ﯽﻣﻮﻤﻋ ﺖﺷاﺪﻬﺑ يﺎﻫ ﺶﻟﺎﭼ زا ﯽﮑﯾ ضراﻮﻋ ﺶﻫﺎﮐ ﻪﺑ ﺪﻧاﻮﺗ ﯽﻣ نﺎﻣرد ﺑ ﻦﯿﺑ رد نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﺖﯿﻌﺿو ﯽﺳرﺮﺑ فﺪﻫ ﺎﺑ ﻪﻌﻟﺎﻄﻣ ﻦﯾا اﺬﻟ .ﺪﻨﮐ ﮏﻤﮐ يرﺎﻤﯿﺑ زا ﯽﺷﺎﻧ
نارﺎﻤﯿ
عﻮﻧ ﺖﺑﺎﯾد 2
.ﺪﺷ مﺎﺠﻧا دﺎﺑآ مﺮﺧ ﺮﻬﺷ رد
شور و داﻮﻣ :ﺎﻫ
ﯽﻌﻄﻘﻣ ﻪﻌﻟﺎﻄﻣ ﻦﯾا رد 392
عﻮﻧ ﺖﺑﺎﯾد ﻪﺑ ﻼﺘﺒﻣ نادﺮﻣ و نﺎﻧز زا ﺮﻔﻧ 2
ﻨﮐ ﻪﻌﺟاﺮﻣ ﻣﺎﺟ ﺰﮐاﺮﻣ ﻪﺑ هﺪﻨ مﺮﺧ ﺮﻬﺷ ﺖﻣﻼﺳ ﻊ
دﺎﺑآ
ﺑ دادﺮﻣ ﺎﺗ ﺖﺸﻬﺒﯾدرا ﻦﯿ 1399
ﻣ ﻊﻤﺟ ياﺮﺑ .ﺪﻨﺘﻓﺮﮔ راﺮﻗ ﯽﺳرﺮﺑ درﻮ ﮏﯿﻓاﺮﮔﻮﻣد) ﯽﺘﺧﺎﻨﺷ ﺖﯿﻌﻤﺟ ﻪﻣﺎﻨﺸﺳﺮﭘ زا ﺎﻫ هداد يروآ
ﻪﻣﺎﻨﺸﺳﺮﭘ و (
ﯽﮑﺴﯾرﻮﻣ نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﯽﺳرﺎﻓ ﻪﺨﺴﻧ Morisky Medication Adherence Scale (MMAS-8)
هدﺎﻔﺘﺳا ﺪﺷ ﺎﻫ هداد ﻞﯿﻠﺤﺗ ياﺮﺑ .
ﻪﺨﺴﻧ زا Version 22 آ وSPSS
زا ﺮﺘﻤﮐ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد يراد ﯽﻨﻌﻣ ﺢﻄﺳ .ﺪﺷ هدﺎﻔﺘﺳا ﯽﻔﯿﺻﻮﺗ يﺎﻫﺰﯿﻟﺎﻧ 05
/0 ﻣزآ زا .دﻮﺑ يﺎﻫ نﻮ
.ﺪﺷ هدﺎﻔﺘﺳا ،ﻞﻘﺘﺴﻣ ﺖﺴﺗ ﯽﺗ و ،ﺮﺸﯿﻓ ﻖﯿﻗد ﺖﺴﺗ ،ﺮﺋﻮﮑﺳا يﺎﮐ ،ﯽﻔﯿﺻﻮﺗ
ﻪﺘﻓﺎﯾ :ﺎﻫ
ﻪﻌﻟﺎﻄﻣ رد نﺎﮔﺪﻨﻨﮐ ﺖﮐﺮﺷ ﯽﻨﺳ ﻦﯿﮕﻧﺎﯿﻣ 91
/ 10 03± / 56 .دﻮﺑ 9 / 68 % ) 270 و نز (ﺮﻔﻧ 1/
31 % ) 122 دﺮﻣ (ﺮﻔﻧ ﺑ سﺎﺳا ﺮﺑ .ﺪﻧدﻮ
عﻮﻤﺠﻣ رد ﯽﮑﺴﯾرﻮﻣ ﻪﻣﺎﻨﺸﺳﺮﭘ زا هﺪﺷ ﺐﺴﮐ هﺮﻤﻧ 219
) ﺮﻔﻧ 9 / 55 % و بﻮﻠﻄﻣ نﺎﻣرد زا ﺖﯿﻌﺒﺗ داﺮﻓا زا ( 173
) ﺮﻔﻧ 1/
44
% ( زا ﺖﯿﻌﺒﺗ
ﻼﯿﺼﺤﺗ ﺖﯿﻌﺿو ،ﻞﻫﺎﺗ ﺖﯿﻌﺿو ،ﺲﻨﺟ يﺎﻫﺮﯿﻐﺘﻣ ﺎﺑ نارﺎﻤﯿﺑ نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﻦﯿﺑ يرادﺎﻨﻌﻣ طﺎﺒﺗرا .ﺪﻨﺘﺷاد بﻮﻠﻄﻣﺎﻧ نﺎﻣرد آرد و ت
ﺪﻣ
ﺎﯿﻫﺎﻣ هﺪﻫﺎﺸﻣ ﺎﻬﻧآ ﻪﻧ ﺪﺷ
نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﺎﺑ لﺎﻐﺘﺷا ﺖﯿﻌﺿو و ﻦﺳ يﺎﻫﺮﯿﻐﺘﻣ صﻮﺼﺧ رد . آ طﺎﺒﺗرا
هﺪﻫﺎﺸﻣ يرادﺎﻨﻌﻣ يرﺎﻣ ﻧ
ﺪﺸ .
ﻪﺠﯿﺘﻧ و ﺚﺤﺑ :يﺮﯿﮔ
عﻮﻧ ﺖﺑﺎﯾد نارﺎﻤﯿﺑ ﻦﯿﺑ رد نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﻪﮐ داد نﺎﺸﻧ ﻪﻌﻟﺎﻄﻣ ﻦﯾا يﺎﻫ ﻪﺘﻓﺎﯾ 2
رد مﺮﺧ ﺑآ ﯽﺑﻮﺧ ﺢﻄﺳ رد دﺎ
ﺪﯾﺎﺑ ﺖﻣﻼﺳ ناراﺬﮔ ﺖﺳﺎﯿﺳ .ﺪﺷﺎﺑ ﯽﻣ ﻢﻫاﺮﻓ ﯽﻄﯾاﺮﺷ ،ﺎﻫ ﻪﻨﯾﺰﻫ ﺶﻫﺎﮐ و تﺎﻣﺪﺧ ﻪﺑ نﺎﺳآ ﯽﺳﺮﺘﺳد ﺎﺑ ﺎﺗ ﺪﻨﻨﮐ شﻼﺗ
دﻮﺷ ﺗ ﻪﻤﻫ ﺎ
.ﺪﻨﻨﮐ ﺖﯿﻌﺒﺗ دﻮﺧ ﯽﻧﺎﻣرد ﺪﻧور زا نارﺎﻤﯿﺑ
هژاو يﺪﯿﻠﮐ يﺎﻫ :
عﻮﻧ ﺖﺑﺎﯾد 2،
،ﯽﮑﺴﯾرﻮﻣ ﻪﻣﺎﻨﺸﺳﺮﭘ ،نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﯽﯾوراد نﺎﻣرد
.
هﺪﯿﮑﭼ
ﻪﻣﺪﻘﻣ
ﺮـﻫ رد ﺖﻣﻼـﺳ يﺎـﻫ ﺶﻟﺎـﭼ زا ﯽـﮑﯾ ناﻮﻨﻋ ﻪﺑ ﺖﺑﺎﯾد يرﻮﺸﮐ ﯽﻣ بﻮﺴﺤﻣ دﻮﺷ
ﻦﯾﺮـﺗ ﻊﯾﺎـﺷ زا ﯽﮑﯾ ناﻮﻨﻋ ﻪﺑ و
ﺎـﯿﻧد يﺎﻫرﻮـﺸﮐ زا يرﺎﯿﺴﺑ رد ﺰﯾر نورد دﺪﻏ يﺎﻫ يرﺎﻤﯿﺑ رد لﺎﺣ ﻒـﻠﺘﺨﻣ يﺎﻫرﻮﺸﮐ ﺖﻣﻼﺳ ﻢﺘﺴﯿﺳ و هدﻮﺑ ﺶﯾاﺰﻓا ﯽـﻣ ﺖـﺧادﺮﭘ نﺎـﻣرد و يﺮﯿﮕﺸﯿﭘ ياﺮﺑ يدﺎﯾز يﺎﻫ ﻪﻨﯾﺰﻫ
ﻨﮐ ﻨ ﺪ ) 1 ( مﻼﻋا ﺖﺷاﺪﻬﺑ ﯽﻧﺎﻬﺟ نﺎﻣزﺎﺳ . هدﺮﮐ
رد ﻪـﮐ ﺖﺳا
لﺎﺳ 1980 زا ﺶﯿﺑ 108 ﻪـﺑ نﺎـﻬﺟ ﺮﺳاﺮﺳ رد ﺮﻔﻧ نﻮﯿﻠﯿﻣ
و ﺪﻧا هدﻮﺑ ﻼﺘﺒﻣ ﺖﺑﺎﯾد لﺎﺳ رد
2014 ﻪـﺑ ناﺰـﯿﻣ ﻦﯾا 422
زا ﺖـﺑﺎﯾد عﻮﯿـﺷ .ﺖـﺳا ﻪـﺘﻓﺎﯾ ﺶﯾاﺰﻓا ﺮﻔﻧ نﻮﯿﻠﯿﻣ 7/
4 رد
لﺎﺳ 1980 ﻪﺑ 5/
8 لﺎﺳ رد 2014 ﺖﺳا ﻪﺘﻓﺎﯾ ﺶﯾاﺰﻓا )
2 ( .
زا يﺮﯿﮕـﺸﯿﭘ ﺖـﻬﺟ ﻒـﻠﺘﺨﻣ يﺎﻫ ﺖﺳﺎﯿﺳ ياﺮﺟا ﻢﻏﺮﯿﻠﻋ يﺎﻫ لﺎﺳ ﻦﯿﺑ ﻪﻧﺎﻔﺳﺎﺘﻣ ،يرﺎﻤﯿﺑ ﻦﯾا 2000
ﺎﺗ 2014 ﺶﯿﺑ
زا 5
% هدﻮﺑ ﺖﺑﺎﯾد يرﺎﻤﯿﺑ زا ﯽﺷﺎﻧ سردوز يﺎﻫﺮﯿﻣ و گﺮﻣ
ﺖﺳا ) 3 ( . و ﻢـﮐ ﺪـﻣآرد ﺎـﺑ يﺎﻫرﻮـﺸﮐ رد يرﺎـﻤﯿﺑ عﻮﯿـﺷ
ﺖﻋﺮـﺳ ﻻﺎـﺑ ﺪـﻣآرد ﺎـﺑ يﺎﻫرﻮـﺸﮐ ﺎـﺑ ﻪـﺴﯾﺎﻘﻣ رد ﻂﺳﻮﺘﻣ ﺖﺳا ﻪﺘﺷاد يﺮﺘﺸﯿﺑ )
4 (.
عﻮـﻧ ﺖـﺑﺎﯾد ﺖـﺑﺎﯾد ﻪـﺑ نﺎﯾﻼﺘﺒﻣ ﺮﺘﺸﯿﺑ ،ﻦﯿﺑ ﻦﯾا رد 2
ﺪﻨﺘﺴﻫ و ﯽﮐﺮﺤﺗ ﻢﮐ ﻪﺠﯿﺘﻧ يدﺎﯾز دوﺪﺣ ﺎﺗ ﺖﺑﺎﯾد عﻮﻧ ﻦﯾا .
ﺪﺷﺎﺑ ﯽﻣ داﺮﻓا نزو ﻪﻓﺎﺿا )
5 ( . ﻔﺳﺎﺘﻣ ﺄ ﻪﻧ
،نﺎـﻣز ﺖـﺷﺬﮔ ﺎـﺑ
ﺚﻋﺎﺑ ﺪﻧاﻮﺗ ﯽﻣ يرﺎﻤﯿﺑ ﻦﯾا ﺿراﻮﻋ
ﯽ ﻪﻠﻤﺟ زا يﺎـﻫ ﺐﯿـﺳآ
ﯽﻧﻮـﺧ يﺎـﻫ گر و بﺎـﺼﻋا ،ﺎﻫ ﻪﯿﻠﮐ ،ﺐﻠﻗ ﻪﺑ يﺪﺟ دﻮـﺷ
.
ﺖـﻧﻮﻔﻋ ،ﺎﭘ ﻢﺧز دﺎﺠﯾا لﺎﻤﺘﺣا يرﺎﻤﯿﺑ ﺪﻧور ﻪﺑ ﻪﺟﻮﺗ مﺪﻋ و
ﺶﯾاﺰﻓا ار ماﺪﻧا ﻊﻄﻗ ﺖﯾﺎﻬﻧ رد ﺪﻫد ﯽﻣ
ﺑﺎـﯾد ﯽﺗﺎﭘﻮﻨﯿﺗر . ﯽﺘ
يرﺎـﻤﯿﺑ ﻦـﯾا .ﺖـﺳا نارﺎـﻤﯿﺑ رد يرﻮﮐ ﻢﻬﻣ ﻞﯾﻻد زا ﯽﮑﯾ ﺖﻠﻋ 6 /2 ﯽﻣ نﺎﻬﺟ رد ﯽﯾﺎﻨﯿﺑﺎﻧ % ﺪﺷﺎﺑ
) 6،7 .(
عﻮـﻧ ﺖﺑﺎﯾد لﺮﺘﻨﮐ ياﺮﺑ 2
زا هدﺎﻔﺘـﺳا ﺮـﺿﺎﺣ لﺎـﺣ رد
ﻪـﺑ ،ﯽﻧﺪﺑ ﺖﯿﻟﺎﻌﻓ و ﯽﯾاﺬﻏ ﻢﯾژر لﺮﺘﻨﮐ ،ﯽﯾوراد يﺎﻫ نﺎﻣرد يرﺎـﻤﯿﺑ لﺮـﺘﻨﮐ ﺚـﻋﺎﺑ ﺪﻧاﻮﺗ ﯽﻣ ﻦﯿﻟﻮﺴﻧا زا هدﺎﻔﺘﺳا هاﺮﻤﻫ دﻮﺷ ) 8 ( يﺎـﻫ نﺎـﻣرد ﻪـﺑ نارﺎﻤﯿﺑ ﺖﯿﻌﺒﺗ و يﺪﻨﺒﯾﺎﭘ مﺪﻋ . ﺶﯾاﺰـﻓا ﻪـﺑ ﺮـﺠﻨﻣ ﺪـﻧاﻮﺗ ﯽـﻣ ﺎﻬﻧآ ياﺮﺑ هﺪﺷ ﻪﺘﻓﺮﮔ ﺮﻈﻧرد
يرﺎﻤﯿﺑ زا ﯽﺷﺎﻧ ضراﻮﻋ و تﻼﮑﺸﻣ دﻮﺷ
) 9 ( يﺎﻫ لﺎﺳ رد . رد ﺖﻣﻼﺳ ناراﺬﮔ ﺖﺳﺎﯿﺳ و ناﺰﯾر ﻪﻣﺎﻧﺮﺑ زا يرﺎﯿﺴﺑ ،ﺮﯿﺧا
ﺎﭘ مﺪﻋ ﻒﻠﺘﺨﻣ يﺎﻫرﻮﺸﮐ نﺎـﻣرد ﻪﺑ ﯽﺘﺑﺎﯾد نارﺎﻤﯿﺑ يﺪﻨﺒﯾ
درﻮﻣ يرﺎﻤﯿﺑ ﺎﺑ ﻂﺒﺗﺮﻣ ﻢﻬﻣ يﺎﻫ ﺶﻟﺎﭼ زا ﯽﮑﯾ ناﻮﻨﻋ ﻪﺑ ار يا ﻪـﻣﺎﻧﺮﺑ ياﺮـﺟا ﺎـﺑ ﺪـﻨﻨﮐ ﯽﻣ شﻼﺗو ﺪﻧا هداد راﺮﻗ ﻪﺟﻮﺗ ﻖﯾﻮﺸﺗ ار نارﺎﻤﯿﺑ ﻒﻠﺘﺨﻣ ﺪﻨﻨﮐ
ﻪـﺑ ار دﻮﺧ نﺎﻣرد ﺪﻧور ﻪﮐ
يﺪﺟ رﻮﻃ ﺪﻨﻨﮐ يﺮﯿﮕﯿﭘ
) 10 (.
عﻮﻧ ﺖﺑﺎﯾد يرﺎﻤﯿﺑ 2
ﺪﻨﻧﺎﻣ ﺰﯿﻧ ناﺮﯾا ﺖﻣﻼﺳ ﺶﺨﺑ رد
هﺪـﺷ ﯽـﻧاواﺮﻓ تﻼﮑـﺸﻣ ﺚﻋﺎﺑ ﺎﯿﻧد يﺎﻫرﻮﺸﮐ زا يرﺎﯿﺴﺑ ﻧﻻﺎﺳ .ﺖﺳا يرﺎـﻤﯿﺑ ﻦﯾا لﺮﺘﻨﮐ ياﺮﺑ يدﺎﯾز يﺎﻫ ﻪﻨﯾﺰﻫ ﻪ
ﯽﻣ ﺖﺧادﺮﭘ ناﺮﯾا رد دﻮﺷ
) 11 ( رد يرﺎـﻤﯿﺑ ﻦـﯾا عﻮﯿـﺷ .
دوﺪﺣ 10
% ﺪﺷﺎﺑ ﯽﻣ ﻪﮐ
لﺎـﺳ رد يرﺎـﻤﯿﺑ ﻪـﺑ ﻼﺘـﺑا ﺪﻧور
ﺖــﺳا ﺶﯾاﺰــﻓا لﺎــﺣ رد ﺮــﯿﺧا يﺎــﻫ )
12 ( رد تﺎــﻌﻟﺎﻄﻣ .
ﺰـﯿﻧ نﺎﻣرد ﻪﺑ ﯽﺘﺑﺎﯾد نارﺎﻤﯿﺑ ندﻮﺒﻧ ﺪﻨﺒﯾﺎﭘ ﻞﻠﻋ صﻮﺼﺧ ﺖــﺳا هﺪــﺷ مﺎــﺠﻧا ناﺮــﯾا رد )
13،14 ( ﻒــﻠﺘﺨﻣ ﻞــﻠﻋ .
ﻪﺑ يﺪﻨﺒﯾﺎﭘ مﺪﻋ رد يدﺮﻓ و ﯽﮕﻨﻫﺮﻓ ،يدﺎﺼﺘﻗا ،ﯽﻋﺎﻤﺘﺟا .ﺪﻧا هﺪﺷ ﯽﯾﺎﺳﺎﻨﺷ نﺎﻣرد ﯽـﻣ نﺎـﻣرد زا ﺖﯿﻌﺒﺗ مﺪﻋ ﻦﯾا
ياﺮﺑ يﺮﺘﺸﯿﺑ تﻼﮑﺸﻣ ﺪﻧاﻮﺗ مﺎﻈﻧ
رد نارﺎـﻤﯿﺑ و ﺖﻣﻼـﺳ
دﺎﺠﯾا ناﺮﯾا ﺪﻨﮐ
) 15 (.
ﻪـﺟﻮﺗ و ناﺮـﯾا رد ﺖـﺑﺎﯾد ﺶﯾاﺰـﻓا ﺪـﻧور ﻪﺑ ﻪﺟﻮﺗ ﺎﺑ ﻋ ﻞﻠﻋ ﻪﺑ يﺪﺟ ﻦـﯾا ،دﻮـﺧ نﺎـﻣرد ﻪـﺑ نارﺎﻤﯿﺑ ﻪﺟﻮﺗ مﺪ
ﻼﺘـﺒﻣ نارﺎـﻤﯿﺑ نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﯽﺳرﺮﺑ فﺪﻫ ﺎﺑ ﻪﻌﻟﺎﻄﻣ عﻮﻧ ﺖﺑﺎﯾد ﻪﺑ 2
مﺎـﺠﻧا ناﺮـﯾا بﺮﻏ رد دﺎﺑآ مﺮﺧ ﺮﻬﺷ رد
ﺪﺷ ﻓﺎﯾ زا هدﺎﻔﺘـﺳا ﺎﺑ ناراﺬﮔ ﺖﺳﺎﯿﺳ و ناﺰﯾر ﻪﻣﺎﻧﺮﺑ . ﻪـﺘ
ﯽـﯾاﺮﭼ زا يﺮـﺘﻬﺑ كرد ﻪـﺑ ﺪﻨﻧاﻮﺗ ﯽﻣ ﻪﻌﻟﺎﻄﻣ ﻦﯾا يﺎﻫ رﺎﻤﯿﺑ نﺎﻣرد زا ﺖﯿﻌﺒﺗ مﺪﻋ عﻮﻧ ﺖﺑﺎﯾد نا
2 ﻪـﺘﻓﺎﯾ ﺖﺳد
ﺎـﻬﻧآ زا ﺮﺗﺮﺛﻮـﻣ يﺎـﻫ ﻪـﻣﺎﻧﺮﺑ و ﺎـﻫ ﺖﺳﺎﯿﺳ ياﺮﺟا رد و هدﺎﻔﺘﺳا ﺪﻨﻨﮐ .
شور و داﻮﻣ ﺎﻫ
،ﯽﻌﻄﻘﻣ ﻪﻌﻟﺎﻄﻣ ﻦﯾا رد 392
ﻼﺘﺒﻣ نادﺮﻣ و نﺎﻧز زا ﺮﻔﻧ
عﻮﻧ ﺖﺑﺎﯾد ﻪﺑ 2
ﺮﻬﺷ ﺖﻣﻼﺳ ﻊﻣﺎﺟ ﺰﮐاﺮﻣ ﻪﺑ هﺪﻨﻨﮐ ﻪﻌﺟاﺮﻣ
سﺮﺘـﺳد رد و ﺪﻨﻤﻓﺪﻫ يﺮﯿﮔ ﻪﻧﻮﻤﻧ شور ﺎﺑ دﺎﺑآ مﺮﺧ ﻦﯿـﺑ
را دادﺮﻣ ﺎﺗ ﺖﺸﻬﺒﯾد 1399
ﺮـﺑ .ﺪـﻨﺘﻓﺮﮔ راﺮـﻗ ﯽـﺳرﺮﺑ درﻮﻣ
/
3هرود ،ﻪﺘﻓﺎﯾ 23
، رﺎﻬﺑ 1400
و قﺮـﺷ ،بﻮـﻨﺟ ،لﺎﻤـﺷ ) ﯽﯾﺎـﯿﻓاﺮﻐﺟ ﻪﻘﻄﻨﻣ رﺎﻬﭼ سﺎﺳا ،دﺎﺑآ مﺮﺧ ﺮﻬﺷ (بﺮﻏ 8
.ﺪﻧﺪﺷ بﺎﺨﺘﻧا ﺖﻣﻼﺳ ﻊﻣﺎﺟ ﺰﮐﺮﻣ
نارﺎـﻤﯿﺑ ،ﺰـﮐﺮﻣ ﺮﻫ ﺖﯿﻌﻤﺟ ﺐﺴﺣ ﺮﺑ و ﯽﻓدﺎﺼﺗ ترﻮﺻ ﻪﺑ ﺖﯿﻌﻤﺟ ﻪﻣﺎﻨﺸﺳﺮﭘ زا هداد يروآ ﻊﻤﺟ ياﺮﺑ .ﺪﻧﺪﺷ بﺎﺨﺘﻧا ﻓاﺮﮔﻮﻣد ) ﯽﺘﺧﺎﻨﺷ ﺖـﯿﻌﺒﺗ ﯽﺳرﺎﻓ ﻪﺨﺴﻧ ﻪﻣﺎﻨﺸﺳﺮﭘ و (ﮏﯿ
ﯽﮑـﺴﯾرﻮﻣ نﺎـﻣرد زا
Morisky Medication Adherence
Scale (MMAS-8)
هدﺎﻔﺘﺳا ﺪﺷ ) 16 (.
ياراد ﯽﮑـﺴﯾرﻮﻣ ﯽﯾوراد نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﻪﻣﺎﻨﺸﺳﺮﭘ 7
ﺳ
= ﺮـﯿﺧ و ﺮﻔﺻ= ﯽﻠﺑ ) يا ﻪﻨﯾﺰﮔ ود لاﻮ 1
ﮏـﯾ و (زﺎـﯿﺘﻣا
= ترﺪﻨﺑ ،ﺮﻔﺻ= ﺰﮔﺮﻫ) يا ﻪﻨﯾﺰﮔ ﺞﻨﭘ لاﻮﺳ 1
تﺎﻗوا ﯽﻫﺎﮔ ،
= 2
= تﺎﻗوا ﺐﻠﻏا ، 3
= ﻪﺸﯿﻤﻫ و 4
هﺮﻤﻧ ﻪﮐ يدﺮﻓ و ﺖﺳا (
6 زا يو بﻮـﻠﻄﻣ ﺖـﯿﻌﺒﺗ ﻪـﻟﺰﻨﻣ ﻪـﺑ ،ﺪـﻨﮐ ﺐﺴﮐ ار ﻻﺎﺑ ﻪﺑ
ﺎـﮑﻤﻫ و هﺪﻧرﺎﮕﻧ ﻂﺳﻮﺗ ﻪﻣﺎﻨﺸﺳﺮﭘ ﻦﯾا .ﺪﺷﺎﺑ ﯽﻣ نﺎﻣرد نار
ﺑز ﻪﺑ ﻪﻤﺟﺮﺗ ﯽﺳرﺎﻓ نﺎ نآ ﯽﯾﺎﯾﺎﭘ و ﯽﯾاور ،
ﺪﺷ ﺪﯿﯾﺄﺗ ) 17 ( .
ﭘ ﻦﯾا ﯽﯾﺎﯾﺎﭘ سﺎﺳا ﺮﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ رد ﻪﻣﺎﻨﺸﺳﺮ
يﺎﻔﻟآ
خﺎﺒﻧوﺮﮐ 81
% .ﺪـﻣآ ﺖﺳد ﻪﺑ ياﺮـﺑ
ﻪـﻌﻟﺎﻄﻣ ﻦـﯾا مﺎـﺠﻧا ﺎـﺑ
و دﺎﺑآ مﺮﺧ نﺎﺘﺳﺮﻬﺷ ﺖﺷاﺪﻬﺑ ﺰﮐﺮﻣ ﺖﺑﺎﯾد ﺪﺣاو ﯽﮕﻨﻫﺎﻤﻫ ﻪﺋارا تاﺪﻨﺘﺴﻣ سﺎﺳا ﺮﺑ نﺎﮔ هﺪﻨﻨﮐ ﺖﮐﺮﺷ بﺎﺨﺘﻧا زا ﺲﭘ ﺖﻬﺟ ﺮﺒﺘﻌﻣ هﺪﺷ ﺗﺄ
ﺪﯿﯾ ﻞـﻣﺎﮐ ﺢﯿﺿﻮﺗ زا ﺲﭘ ،داﺮﻓا يرﺎﻤﯿﺑ
ﻧا شور ،ﻪﻌﻟﺎﻄﻣ فاﺪﻫا ﯽـﺒﺘﮐ ﻪﻣﺎﻧ ﺖﯾﺎﺿر ﺬﺧا ﺎﺑ ،رﺎﮐ مﺎﺠ
،
ﯽﺗرﻮـﺻ رد و ﻪـﺘﻓﺮﮔ راﺮﻗ ﺎﻬﻧآ رﺎﯿﺘﺧا رد ﺎﻫ ﻪﻣﺎﻨﺸﺳﺮﭘ ﻪـﮐ
زا ﯽـﮑﯾ ﻂـﺳﻮﺗ ،دﻮـﺒﻧ ﻪﻣﺎﻨـﺸﺳﺮﭘ ﻞﯿﻤﮑﺗ داﻮﺳ ياراد دﺮﻓ ﻞـﯿﻤﮑﺗ يرﻮـﻀﺣ ترﻮﺻ ﻪﺑ ناﺮﮕﺸﻫوﮋﭘ ﺪﻧﺪـﺷ
ﻞـﯿﻟد ﻪـﺑ .
داﺮـﻓا تﺎـﻋﻼﻃا ندﻮﺑ ﻪﻧﺎﻣﺮﺤﻣ ﻞﺻا ،ﯽﻗﻼﺧا ﻦﯾزاﻮﻣ ﺖﯾﺎﻋر .ﺖﻓﺮﮔ راﺮﻗ ﻪﺟﻮﺗ درﻮﻣ ﻪﻌﻟﺎﻄﻣ ﻪﺑ جوﺮﺧ و دورو يﺎﻫرﺎﯿﻌﻣ
يﺎﻫرﺎﯿﻌﻣ دورو
:ﻞﻣﺎﺷ د ﻪـﺑ ﻼﺘـﺑا مﺪـﻋ ﯾ
ﺖـﺑﺎ عﻮـﻧ ـﯾ ﮏ و
دﯾ ﺖﺑﺎ ﺎﺑ رادر ي
، ﺨﺸﺗ ﯿ ﺺ د ﯾ ﺖﺑﺎ ود عﻮﻧ ﺎﺑ ﺗﺄ ﺪﯿﯾ ﺞﻟﺎـﻌﻣ ﮏـﺷﺰﭘ
تاﺪﻨﺘﺴﻣ ﻪﺋارا و ﻞﻗاﺪﺣ ﺖﺷﺬﮔ ،
ﯾ ﮏ ﺨـﺸﺗ نﺎـﻣز زا لﺎﺳ ﯿ
ﺺ
دﺮﻓ رد يرﺎﻤﯿﺑ
، ﺎﺿر ﯾ ﺖ اﺮـﺑ ﻪـﻧﺎﻫﺎﮔآ ي
ﺶﻫوﮋـﭘ رد ﺖﮐﺮـﺷ و
.ﻪﺘﺷﺬﮔ لﺎﺴﮑﯾ لﻮﻃ رد ود عﻮﻧ ﺖﺑﺎﯾد يﺎﻫوراد فﺮﺼﻣ ﻣ
يﺎﻫرﺎﯿﻌ وﺮﺧ :ﻞﻣﺎﺷ ج ﺎﻤﺗ مﺪـﻋ
ـﯾ ﻞ ﺑﯿ رﺎـﻤ ﻪـﻣادا ﻪـﺑ
رﺎﮑﻤﻫ ي ﻠﺣﺮﻣ ﺮﻫ رد ا ﻪ
،ﺶﻫوﮋﭘ ز ﮔدﺎﺘﻓا رﺎﮐ زا
ﻦﺘﺷاد و ﯽ
ﻧاﻮﺗﺎﻧ و ﻪﺘﻓﺮﺸﯿﭘ ضراﻮﻋ ﯽﺘﺒﻗاﺮﻣدﻮﺧ يﺎﻫرﺎﺘﻓر مﺎﺠﻧا رد ﯽ
،
ﻪﺨـﺴﻧ زا ﺎـﻫ هداد ﻞـﯿﻠﺤﺗ ياﺮﺑ .دﻮﺑ
Version 22
وSPSS
رد يراد ﯽـﻨﻌﻣ ﺢﻄـﺳ .ﺪـﺷ هدﺎﻔﺘـﺳا ﯽﻔﯿـﺻﻮﺗ يﺎﻫﺰﯿﻟﺎﻧآ ا ﺮﺘﻤﮐ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ ز
05 /0 ﯽﻔﯿـﺻﻮﺗ يﺎـﻫ نﻮﻣزآ زا .دﻮﺑ ،
ﻓ ﻖـﯿﻗد ﺖـﺴﺗ ،ﺮﺋﻮﮑـﺳا يﺎﮐ ،ﻞﻘﺘـﺴﻣ ﺖـﺴﺗ ﯽـﺗ و ،ﺮـﺸﯿ
.ﺪﺷ هدﺎﻔﺘﺳا
ﻪﺘﻓﺎﯾ ﺎﻫ
ﻪـــﻌﻟﺎﻄﻣ رد نﺎﮔﺪـــﻨﻨﮐ ﺖﮐﺮـــﺷ ﯽﻨـــﺳ ﻦﯿﮕﻧﺎـــﯿﻣ 91 / 10 03± / 56 ﺖﮐﺮـﺷ داﺮﻓا ﯽﻧاواﺮﻓ ﺪﺻرد ﻦﯾﺮﺘﺸﯿﺑ .دﻮﺑ
ﺖﯿﻌـﺿو ﺮـﻈﻧ زا هﺪﻨﻨﮐ ﺗﺄ
ﻞـﻫ
، ) ﻞـﻫﺎﺘﻣ 4/
82
،(%
ﺮـﻈﻧ زا
تﻼﯿﺼﺤﺗ
، ) ﻢﻠﭙﯾد ﺮﯾز 4/
34 % زا ،(
لﺎﻐﺘـﺷا ﺖﯿﻌـﺿو ﺮﻈﻧ
،
) راد ﻪﻧﺎﺧ 6/
53 % ﺪﻣآرد ﺮﻈﻧ زا ،(
، ﺪﻣآرد ياراد ﻪﻧﺎﻫﺎﻣ
ـﺑ ﻦﯿ
1 ﺎﺗ 3 ) نﻮﯿﻠﯿﻣ 3/
51 % ﺰـﯿﻧ ﺖﯿﺴﻨﺟ ﺮﻈﻧ زا .ﺪﻧدﻮﺑ ( 9/
68
) % 270 و نز (ﺮـــﻔﻧ 1/
31 ) % 122 .ﺪـــﻧدﻮﺑ دﺮـــﻣ (ﺮـــﻔﻧ
و بﻮـﻠﻄﻣ نﺎـﻣردزا ﺖﯿﻌﺒﺗ نارﺎﻤﯿﺑ ﮏﯿﻓاﺮﮔﻮﻣد تﺎﺼﺨﺸﻣ مﺮﺧ ﺮﻬﺷ رد بﻮﻠﻄﻣﺎﻧ لوﺪﺟ رد دﺎﺑآ
1 .ﺖﺳا هﺪﻣآ
آ ظﺎـﺤﻟ ﻪـﺑ يرادﺎﻨﻌﻣ طﺎﺒﺗرا ﻪﮐ داد نﺎﺸﻧ ﺞﯾﺎﺘﻧ يرﺎـﻣ
ﺖﯿﻌـﺿو ،ﺲﻨﺟ يﺎﻫﺮﯿﻐﺘﻣ ﺎﺑ نارﺎﻤﯿﺑ نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﻦﯿﺑ ﺗﺄ ﻞﻫ دراد دﻮﺟو ﺎﻬﻧآ ﻪﻧﺎﯿﻫﺎﻣ ﺪﻣآرد و تﻼﯿﺼﺤﺗ ﺖﯿﻌﺿو ، )
05 /0
<
.( P
ﻪﺑ يرﻮـﻃ ﻪـﮐ ﺖـﯿﻌﺒﺗ نﺎـﻣرد زا ﯽـﯾوراد
رد
نارﺎــﻤﯿﺑ ﺚــﻧﺆﻣ
و نارﺎــﻤﯿﺑ ﺘﻣ ﺄ ﻞــﻫ و ﺢﻄــﺳ ﺎــﺑ نارﺎــﻤﯿﺑ
و ﻻﺎﺑ تﻼﯿﺼﺤﺗ ﺪﻣآرد
ﻻﺎـﺑ ﻪﻧﺎﯿﻫﺎﻣ ﻪـﺑ
رﻮـﻃ ﯽـﻨﻌﻣ يراد
ﻻﺎﺑ ﺮﺗ زا ﻦﯾﺮﯾﺎﺳ دﻮﺑ . نارﺎـﻤﯿﺑ نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﻦﯿﺑ ﯽﻃﺎﺒﺗرا
هﺪﻫﺎـﺸﻣ لﺎﻐﺘﺷا ﺖﯿﻌﺿو و ﻦﺳ ﺮﯿﻐﺘﻣ ﺎﺑ ﺪـﺸﻧ
سﺎـﺳا ﺮـﺑ .
عﻮـﻤﺠﻣ رد ﯽﮑـﺴﯾرﻮﻣ ﻪﻣﺎﻨﺸﺳﺮﭘ زا هﺪﺷ ﺐﺴﮐ هﺮﻤﻧ 219
) ﺮﻔﻧ 9/
55%
و بﻮﻠﻄﻣ نﺎﻣرد زا ﺖﯿﻌﺒﺗ داﺮﻓا زا ( 173
ﺮـﻔﻧ
) 1/
44
% .ﺪﻨﺘﺷاد بﻮﻠﻄﻣﺎﻧ نﺎﻣرد زا ﺖﯿﻌﺒﺗ (
لوﺪﺟ 1 . تﺎﺼﺨﺸﻣ مﺮﺧ ﺮﻬﺷ رد بﻮﻠﻄﻣﺎﻧ و بﻮﻠﻄﻣ نﺎﻣردزا ﺖﯿﻌﺒﺗ نارﺎﻤﯿﺑ ﮏﯿﻓاﺮﮔﻮﻣد
دﺎﺑآ
ﺮﯿﻐﺘﻣ ﻞﮐ ﻊﻤﺟ
نﺎﻣرد زا ﺖﯿﻌﺒﺗ (بﻮﻠﻄﻣ )
نﺎﻣرد زا ﺖﯿﻌﺒﺗ (بﻮﻠﻄﻣﺎﻧ )
P-Value
داﺪﻌﺗ ﺪﺻرد
داﺪﻌﺗ ﺪﺻرد
ﻦﺳ زا ﺮﺘﻤﮐ
40 لﺎﺳ 107
48 9/
44
% 59
1/
55
% 0/48
يﻻﺎﺑ 40 لﺎﺳ 285
153 7/
53
% 132 3/
46
%
ﺲﻨﺟ نز
270 153
7/
56
% 117 3/
43
% 0/000
دﺮﻣ 122
48 4/
39
% 74
6/
60
%
ﻞﻫﺎﺗ ﺖﯿﻌﺿو دﺮﺠﻣ
21 13
62
% 8
38
%
0/000 %421/ 136 %579/ 187 323 ﻞﻫﺎﺘﻣ
ﻪﻘﻠﻄﻣ 5
4 80
% 1
20
%
هﺪﺷ تﻮﻓ ﺮﺴﻤﻫ 43
26 5/
60
% 17
5/
39
%
تﻼﯿﺼﺤﺗ ﺖﯿﻌﺿو ﯽﺑ
داﻮﺳ 76
37 7/
48
% 39
3/
51
% 0/001
ز ﻢﻠﭙﯾدﺮﯾ 135
74 9/
54
% 61
1/
45
%
ﻢﻠﭙﯾد 100
62 62
% 38
38
%
ﯽﻧادرﺎﮐ 15
10 7/
66
% 5
3/
33
%
ﯽﺳﺎﻨﺷرﺎﮐ 45
19 3/
42
% 26
7/
57
%
ﺪﺷرا ﯽﺳﺎﻨﺷرﺎﮐ 17
11 7/
64
% 6
3/
35
%
يﺮﺘﮐد 4
3 75
% 1
25
%
لﺎﻐﺘﺷا ﺖﯿﻌﺿو ﺪﻨﻣرﺎﮐ
61 39
9/
63
% 22
1/
36
%
0/64
ﻢﻠﻌﻣ 26
17 4/
65
% 9
6/
34
%
دازآ 50
11 22
% 39
78
%
رﺎﮑﯿﺑ 15
3 20
% 12
80
%
راد ﻪﻧﺎﺧ 210
102 6/
48
% 108 4/
51
%
ﯽﻣﺎﻈﻧ 9
5 6/
55
% 4
4/
44
%
ﻪﺘﺴﺸﻧزﺎﺑ 21
13 9/
61
% 8
1/
38
%
ﺪﻣآرد ﺖﯿﻌﺿو ﻪﻧﺎﻫﺎﻣ ﺮﯾز
1 نﺎﻣﻮﺗ نﻮﯿﻠﯿﻣ 73
28 36
/ 38
% 45 64
/ 61
% 001
/0 %582/ 117 %418/ 84 201 نﻮﯿﻠﯿﻣ3 ﺎﺗ1 ﻦﯿﺑ
3 ﺎﺗ 5 نﻮﯿﻠﯿﻣ 81
22 17
/ 27
% 59 83
/ 72
%
يﻻﺎﺑ 5 نﻮﯿﻠﯿﻣ 37
18 7/
48
% 19
3/
51
%
ﻞﮐ ﻊﻤﺟ
219 9/
55
% 173 1/
44
%
ﻪﺠﯿﺘﻧ و ﺚﺤﺑ يﺮﯿﮔ
ﯽﻨﺳ ﻦﯿﮕﻧﺎﯿﻣ 91
/ 10 03± / 56 هﺪـﺷ ﺖـﻓﺎﯾ ﻪـﻌﻟﺎﻄﻣ ﻦﯾا رد
ﻪﺑ ﮏﯾدﺰﻧ 16 /9 15± / 58 و لﺎﺳ 3/
12 61± هﺪـﺷ ﺖـﺒﺛ لﺎﺳ
ﺪـﺷﺎﺑ ﯽﻣ ﺎﮑﯾﺮﻣآ هﺪﺤﺘﻣ تﻻﺎﯾا و يﺰﻟﺎﻣ زا رﺎﮐ رد )
18،19 (.
ﻦـﯾا
تﺎـﻌﻟﺎﻄﻣ ﯽﻨـﺳ ﻦﯿﮕﻧﺎـﯿﻣ ﯽـﻠﮐ ﺪﻧور هﺪﻨﻫد نﺎﺸﻧ ﺪﻧاﻮﺗ ﯽﻣ ﺮﻣا عﻮـﻧ ﯽﺘﺑﺎﯾد نارﺎﻤﯿﺑ نﺎﯿﻣ رد ﻪﺑﺎﺸﻣ 2
ﺪـﺷﺎﺑ نﺎـﻬﺟ ﺮـﺳاﺮﺳ رد .
عﻮـﻧ ﯽﺘﺑﺎﯾد نارﺎﻤﯿﺑ يﺪﻨﺒﯾﺎﭘ ﺖﯿﻌﺿو ﯽﺳرﺮﺑ ﻪﺑ ﺮﺿﺎﺣ ﻪﻌﻟﺎﻄﻣ 2
ا ﺎﺑ دﺎﺑآ مﺮﺧ ﺮﻬﺷ رد ﺖﺧادﺮﭘ ﯽﮑﺴﯾرﻮﻣ ﻪﻣﺎﻨﺸﺳﺮﭘ زا هدﺎﻔﺘﺳ
.
ﻪﮐ داد نﺎﺸﻧ ﻪﻌﻟﺎﻄﻣ ﻦﯾا يﺎﻫ ﻪﺘﻓﺎﯾ 9/
55
% نارﺎﻤﯿﺑ زا
ﺪﻧراد بﻮﻠﻄﻣ نﺎﻣرد زا ﺖﯿﻌﺒﺗ ﺎﺑ ﻪﮐ
يﺎـﻫ ﻪﺘﻓﺎﯾ ﯽﺗﺎـﻌﻟﺎﻄﻣ
ﻪﯾﺮﺠﯿﻧ يﺎﻫرﻮﺸﮐ رد ﻪﮐ )
20 ( ، تارﺎﻣا ) 21 ( ، ﻦـﺑ ﻪﻌﻟﺎﻄﻣ
ناﺮــﯾا رد نارﺎــﮑﻤﻫ و يﻮــﺿر )
13 ( ﺖــﺳا هﺪــﺷ مﺎــﺠﻧا ﻬﺘـﺷاد ﯽﻧاﻮﺨﻤﻫ
ﻮ و قﻼـﺸﻗ ﻪـﻌﻟﺎﻄﻣ رد ناﺰـﯿﻣ نارﺎـﮑﻤﻫ
ﻦـﯾا يﺎـﻫ ﻪـﺘﻓﺎﯾ زا ﺮـﺘﻤﮐ ود عﻮـﻧ ﯽﺘﺑﺎـﯾد نارﺎﻤﯿﺑ ﺖﯿﻌﺒﺗ ﺖﺳا هﺪﺷ شراﺰﮔ ﻪﻌﻟﺎﻄﻣ )
14 ( .
ـﻫ ﻪـﻣﺎﻧﺮﺑ ياﺮـﺟا ﻞـﯿﻟد ﻪﺑ ﺪﻧاﻮﺗ ﯽﻣ ﺎﻫ ﻪﺘﻓﺎﯾ توﺎﻔﺗ ﻦﯾا يﺎ
يﺎﻫرﻮـﺸﮐ رد ﺖﻣﻼـﺳ ﺶـﺨﺑ ﻂـﺳﻮﺗ يرﺎـﻤﯿﺑ لﺮﺘﻨﮐ ﻒﻠﺘﺨﻣ ﯿﺧا يﺎﻫ لﺎﺳ رد ﯽﺘﻬﺟ زا .ﺪﺷﺎﺑ ﻒﻠﺘﺨﻣ ناﺮـﯾا ﺖﻣﻼـﺳ مﺎﻈﻧ ،ﺮ
نارﺎـﻤﯿﺑ ياﺮـﺑ يﺪـﯾﺪﺟ يﺎـﻫ ﻪـﻣﺎﻧﺮﺑ ﺖﻣﻼـﺳ ﻊﻣﺎـﺟ ﺰﮐاﺮﻣ رد ﺑﺎـﯾد نارﺎـﻤﯿﺑ ﺎـﺗ ﺖﺳا هﺪﺷ شﻼﺗ نآ سﺎﺳا ﺮﺑ و اﺮﺟا ﯽﺘﺑﺎﯾد ﯽﺘ
ﯽﺑﺎـﯾزرا درﻮـﻣ تﺎﻣﺪـﺧ نﺎﮔﺪـﻨﻫد ﻪﺋارا ﻂﺳﻮﺗ ﻢﻈﻨﻣ ترﻮﺻ ﻪﺑ .ﺪﻧﺮﯿﮔ راﺮﻗ ﺮﻤﺘﺴﻣ ﻦــﯾا ياﺮــﺑ هدﺮﺘــﺴﮔ ﯽـﺷزﻮﻣآ يﺎــﻫ ﻪــﻣﺎﻧﺮﺑ ﻦﯿـﻨﭽﻤﻫ
لﺎـﺣ رد ﺰـﯿﻧ نارﺎﻤﯿﺑ زا يرﺎﯿـﺴﺑ لﺎـﺣ ﺮـﻫ ﻪـﺑ .ﺖـﺳاﺮﺟا
/
5هرود ،ﻪﺘﻓﺎﯾ 23
، رﺎﻬﺑ 1400
ﺎـﻬﻧآ ﻂـﺳﻮﺗ نﺎـﻣرد ﻪﺑ يﺪﻨﺒﯾﺎﭘ مﺪﻋ ﻪﮐ ﺪﻨﻧاد ﯽﻣ نارﺎﻤﯿﺑ اﺰـﻓا ﻪـﺑ ﺮـﺠﻨﻣ ﺪـﻧاﻮﺗ ﯽﻣ يﺎـﻫ ﺖـﺒﻗاﺮﻣ ياﺮـﺑ ﺎـﺿﺎﻘﺗ ﺶﯾ
ﯽﯾﺎﭘﺮﺳ ﻪﺑ زﺎﯿﻧ ، ،ﯽﺘـﺷاﺪﻬﺑ يﺎـﻫ ﺖـﺒﻗاﺮﻣ هﺪﯿﭽﯿﭘ تﺎﻣﺪﺧ
رد نﺪــﺷ يﺮﺘــﺴﺑ و ﺲــﻧاژروا يﺎــﻫ ﺶــﺨﺑ رد ﺖــﯾﺰﯾو دﻮﺷ نﺎﺘﺳرﺎﻤﯿﺑ ﯽﻬﺟﻮـﺗ ﻞـﺑﺎﻗ ﯽﻟﺎـﻣ رﺎـﺑ ﯽﮕﻤﻫ ﻪﮐ ،
ﺮـﺑ ار
دراﺬﮔ ﯽﻣ ﯽﺘﺷاﺪﻬﺑ يﺎﻫ ﺖﺒﻗاﺮﻣ و نارﺎﻤﯿﺑ شود )
22 (
.
تﻼﯿـﺼﺤﺗ ﺢﻄـﺳ ﻪـﮐ داد نﺎـﺸﻧ ﻪـﻌﻟﺎﻄﻣ ﻦﯾا يﺎﻫ ﻪﺘﻓﺎﯾ ﻞﻣاﻮﻋ زا ﯽﮑﯾ نارﺎﻤﯿﺑ ﺮﺛﺆﻣ
ﯽـﻣ ﺎﻬﻧآ نﺎﻣرد زا ﺖﯿﻌﺒﺗ رد ﺑ
ﺪـﺷﺎ
ناﺮـﯾا رد يﻮﺿر ﻦﺑ يﺎﻫ ﻪﺘﻓﺎﯾ ﺎﺑ ﻪﮐ )
13 ( ﻪـﮐ ﯽﺗﺎـﻌﻟﺎﻄﻣ و د
ر
ﻪﯿﮐﺮﺗ ) 23 ( دراد ﯽﻧاﻮﺨﻤﻫ ﺖﺳا هﺪﺷ مﺎﺠﻧا ﺎﮑﯾﺮﻣا و )
24 ( . ـﺑ ﻪ
يﺪــﻨﺒﯾﺎﭘ ﻻﺎــﺑ تﻼﯿــﺼﺤﺗ ﺢﻄــﺳ ياراد نارﺎــﻤﯿﺑ ﻪــﮐ يرﻮــﻃ ﻪـﮐ ﯽﻧارﺎـﻤﯿﺑ ﺪـﺳر ﯽـﻣ ﺮﻈﻧ ﻪﺑ .ﺪﻧراد دﻮﺧ نﺎﻣرد ﻪﺑ يﺮﺘﺸﯿﺑ ﺑ ﯽﻫﺎـﮔآ ﺪﻨﺘـﺴﻫ يﺮﺗﻻﺎـﺑ تﻼﯿﺼﺤﺗ ﺢﻄﺳ ياراد رد يﺮﺘـﺸﯿ
نﺎـﻣرد ﻪﺑ يﺪﻨﺒﯾﺎﭘ مﺪﻋ ضراﻮﻋ و ﺎﻫوراد ،دﻮﺧ نﺎﻣرد صﻮﺼﺧ رد ﺎـﻫوراد ﺖـﯿﻤﻫا درﻮـﻣ رد يﺮﺘﺸﯿﺑ ﺶﻧاد و ﺪﻨﻨﮐ ﯽﻣ ﺐﺴﮐ يرﺎﻤﯿﺑ لﺮﺘﻨﮐ ﯽﻣ ﺖﺳﺪﺑ يرﺎﻤﯿﺑ ضراﻮﻋ زا يﺮﯿﮔﻮﻠﺟ و نﺎﺷ
ﺪﻧروآ ) 25 ( ﺎـﮑﯾﺮﻣآ رد ﺰـﯿﻧ ﯽﺗﺎـﻌﻟﺎﻄﻣ ﻪـﺘﺒﻟا . )
26 ( ﭘﺎﮕﻨـﺳ و رﻮ
) 27 ( دﻮﺑ هﺪﺷ مﺎﺠﻧا ﻪﮐ
و تﻼﯿـﺼﺤﺗ ﺢﻄﺳ ﻦﯿﺑ ﯽﻃﺎﺒﺗرا ﭻﯿﻫ
.ﺪﻧدﻮﺑ هدﺮﮑﻧ اﺪﯿﭘ نﺎﻣرد ﻪﺑ يﺪﻨﺒﯾﺎﭘ ز رد نﺎﻣرد ﻪﺑ يﺪﻨﺒﯾﺎﭘ ،ﻪﻌﻟﺎﻄﻣ ﻦﯾا ﺞﯾﺎﺘﻧ ﺎﺑ ﻖﺑﺎﻄﻣ نﺎـﻧ
رد هﺪـﺷ مﺎـﺠﻧا تﺎﻌﻟﺎﻄﻣ ﺎﺑ ﻪﮐ ﺖﺳاﺮﺘﺸﯿﺑ نادﺮﻣ ﻪﺑ ﺖﺒﺴﻧ ﻪﯾﺮﺠﯿﻧ ) 20 ( دراد ﯽﻧاﻮـﺨﻤﻫ ناﺮـﯾا رد يﻮﺿر ﻦﺑ و )
13 ( .
ﻠﻋ ﻪﺑ ﺪﻧاﻮﺗ ﯽﻣ توﺎﻔﺗ ﻦﯾا ا ﺖـﺒﻗاﺮﻣ ياﺮـﺑ نﺎﻧز هﺎﮔﺪﯾد ﺖ
ز
ﻞـﯾﺎﻤﺗ نﺎـﻧز .ﺪـﺷﺎﺑ ﯽـﻣ ﻒﻠﺘﺨﻣ ﺎﻫ يرﺎﻤﯿﺑ ﻞﺑﺎﻘﻣ رد دﻮﺧ هﺮـﻬﺑ ﺖﻣﻼﺳ تﺎﻣﺪﺧ زا ﻒﻠﺘﺨﻣ ﻊﻗاﻮﻣ رد ﺎﺗ ﺪﻧراد يﺮﺘﺸﯿﺑ ﯽﻣ يﺮﺘﺸﯿﺑ شﻼﺗ ﺪﻧﻮﺷ ﻼﺘﺒﻣ يرﺎﻤﯿﺑ ﻪﺑ ﻪﭽﻧﺎﻨﭼ و ﺪﻧﺮﯿﮕﺑ ﺪﻨﺑﺎﯾ دﻮﺒﻬﺑ ﺮﺘﻌﯾﺮﺳ ﺎﺗ ﺪﻨﻨﮐ )
14 ( .
داد نﺎـﺸﻧ ﻪﯿﮐﺮﺗ و ﺎﮑﯾﺮﻣآ رد هﺪﺷ مﺎﺠﻧا تﺎﻌﻟﺎﻄﻣ
، ﻦﺘـﺷاد
نﺎـﻣرد ﻪـﺑ بﻮـﻠﻄﻣ يﺪﻨﺒﯾﺎﭘ رد ﺮﺗﻻﺎﺑ ﺪﻣآرد ﺢﻄﺳ ﺮﺛﺆﻣ
ﺖـﺳا
ﻬﮐ ﻪﻌﻟﺎﻄﻣ ﻦﯾا يﺎﻫ ﻪﺘﻓﺎﯾ ﺎﺒ دراد ﯽﻧاﻮـﺨﻤﻫ
) 24،26 ( ﺮـﻈﻧ ﻪـﺑ .
راد يﺮﺗﻻﺎـﺑ ﺪـﻣآرد ﺢﻄـﺳ ﻪـﮐ يداﺮﻓا ﺪﺳر ﯽﻣ ﺮـﺑ هوﻼـﻋ ﺪـﻧ
ﯽﻣ ،ﯽﺘﻟود ﺶﺨﺑ تﺎﻣﺪﺧ ،ﯽـﺻﻮﺼﺧ ﺶـﺨﺑ تﺎﻣﺪـﺧ زا ﺪﻨﻧاﻮﺗ
.ﺪﻧﺮﯿﮔ هﺮﻬﺑ ﺰﯿﻧ لﺰﻨﻣ رد تﺎﻣﺪﺧ و ﺮﺗ ناﺮﮔ يﺎﻫوراد ﯽﻧارﺎـﻤﯿﺑ
ﻪﮐ ﯽﻟﺎﻣ ﻂﯾاﺮﺷ و
ﺪﻧراﺪﻧ ﯽﯾﻻﺎﺑ ﺪﻣآرد ﺢﻄﺳ
، ﺪـﻨﻨﮐ ﯽـﻣ ﯽﻌﺳ
ﯽﺘﻟود تﺎﻣﺪﺧ زا ﺮﺘﻤﮐ ﻦﮑـﺴﻣ و اﺬﻏ يﺎﻫ ﻪﻨﯾﺰﻫ و ﺪﻧﺮﯿﮔ هﺮﻬﺑ
ﺖﻣﻼـﺳ تﺎﻣﺪﺧ ﺖﻓﺎﯾرد ياﺮﺑ ﺖﺧادﺮﭘ ﺶﻫﺎﮐ ﺮﺑ ﺪﻧاﻮﺗ ﯽﻣ ﺰﯿﻧ نﺎﻣرد ﺖﯿﺿو ﯽﺳرﺮﺑ ياﺮﺑ ﺎﻬﻧآ ﺮﺘﻤﮐ يﺎﻫ ﺖﯾﺰﯾو و ﺮﺛﺆﻣ
ﺪـﺷﺎﺑ
) 28،29 ( . ﻪـﻨﯾﺰﻫ ﺎـﺗ ﺪـﻨﻨﮐ ﯽﻣ شﻼﺗ يرﺎﻤﯿﺑ ﮏﯾ ﺎﺑ ﻪﺟاﻮﻣ رد داﺮﻓا
ﺖﯾﺮﯾﺪـﻣ ار يرﺎـﻤﯿﺑ ﺎﺑ ﻂﺒﺗﺮﻣ يﺎﻫ ﺪـﻨﻨﮐ
ياراد ﻪـﮐ يداﺮـﻓا .
ﻞﻐﺷ ﺮـﻄﺧ ضﺮـﻌﻣ رد ﺮﺘﺸﯿﺑ ﺪﻨﺘﺴﻫ رﺎﮑﯿﺑ ﺎﯾ ﺪﻨﺘﺴﯿﻧ ﺐﺳﺎﻨﻣ
ﺪﻨﺘﺴﻫ ﺎﻬﯾرﺎﻤﯿﺑ يﺪﺟ ضراﻮﻋ )
30 ( ﻪـﻌﻟﺎﻄﻣ ﻦـﯾا يﺎـﻫ ﻪﺘﻓﺎﯾ .
و ﺐﺳﺎﻨﻣ ﻞﻐﺷ ﻦﺘﺷاد ﻪﮐ داد نﺎﺸﻧ ﯽﻣ ﺐﺳﺎﻨﻣ ﺪﻣآرد ﻊﺒﺗ ﻪﺑ
يﺪـﺟ ترﻮـﺻ ﻪـﺑ ار دﻮـﺧ نﺎﻣرد ﺎﺗ ﺪﻨﮐ ﺐﯿﻏﺮﺗ ار داﺮﻓا ﺪﻧاﻮﺗ ﺎـﻗ ،ﺪـﻧراﺪﻧ ﺐـﺳﺎﻨﻣ ﻞﻐﺷ ﻪﮐ يداﺮﻓا زا يرﺎﯿﺴﺑ .ﺪﻨﻫد ﻪﻣادا د
ر
ﺎﻄﻣ يﺎـﻫ ﻪﺘﻓﺎﯾ .ﺪﻨﻨﮐ ﻞﻣﺎﮐ ار دﻮﺧ نﺎﻣرد ﺪﻧور ﺎﺗ ﺪﻨﺘﺴﯿﻧ ﻪـﻌﻟ
يرﺎـﮑﯿﺑ ﻪـﮐ ﺪﻫد ﯽﻣ نﺎﺸﻧ ﺰﯿﻧ هﺪﺷ مﺎﺠﻧا ﻪﯾﺮﺠﯿﻧ رد ﻪﮐ يا و
نارﺎـﻤﯿﺑ رد نﺎﻣرد ﻪﺑ يﺪﻨﺒﯾﺎﭘ ﺶﻫﺎﮐ ﺚﻋﺎﺑ ﺐﺳﺎﻨﻣ ﻞﻐﺷ دﻮﺒﻧ ﺖﺳا هﺪﺷ )
20 ( .
رد نﺎـﻣرد ﻪـﺑ يﺪﻨﺒﯾﺎﭘ ناﺰﯿﻣ ﻪﮐ داد نﺎﺸﻧ ﻪﻌﻟﺎﻄﻣ ﻦﯾا عﻮـﻧ ﯽﺘﺑﺎـﯾد نارﺎﻤﯿﺑ 2
ﻊﻣﺎـﺟ ﺰـﮐاﺮﻣ ﻪـﺑ هﺪـﻨﻨﮐ ﻪـﻌﺟاﺮﻣ
ﺰـﮐاﺮﻣ ﻦﯾا .ﺖﺳا بﻮﻠﻄﻣ دﺎﺑآ مﺮﺧ ﺮﻬﺷ رد ﺖﻣﻼﺳ تﺎﻣﺪﺧ يﺎﻫ ﺖﺳﺎﯿﺳ ياﺮﺟا ﺎﺑ ﺮﺛﺆﻣ
دﻮـﺒﻬﺑ ﺚـﻋﺎﺑ ﺪﻧا ﻪﺘﺴﻧاﻮﺗ دﻮﺧ
ﯾا و نﺎـﻣرد ﺪـﻧور صﻮﺼﺧ رد نارﺎﻤﯿﺑ ﯽﻫﺎﮔآ سﺎـﺴﺣ دﺎـﺠ
ﺎﻬﻧآ رد نﺎﻣرد ﺪﻧور ﻪﺑ ﺖﺒﺴﻧ ﺮﺘﺸﯿﺑ يزﺎﺳ ﺪﻧﻮﺷ
ﻦﯿـﻨﭽﻤﻫ .
ناراﺬـﮔ ﺖـﺳﺎﯿﺳ ،ﺎـﻫ ﻪـﻣﺎﻧﺮﺑ ﻦـﯾا دﻮـﺒﻬﺑ ﻦﻤﺿ ﺖﺳا مزﻻ ﻦـﯾا زا ﯽﻟﺎﻣ يﺎﻫ ﺖﯾﺎﻤﺣ ﻦﻤﺿ ﺎﺗ ﺪﻨﻨﮐ شﻼﺗ ﺪﯾﺎﺑ ﺖﻣﻼﺳ .ﺪـﻨﻨﮐ ﻢﻫاﺮـﻓ ﺰـﯿﻧ ﺎـﻬﻧآ ياﺮـﺑ ار ﺐـﺳﺎﻨﻣ يﺎﻫ ﻪﻤﯿﺑ ،داﺮﻓا ﺶـﺷﻮﭘ و تﺎﻣﺪﺧ ﻪﺑ نﺎﺳآ ﯽﺳﺮﺘﺳد هدﺮﺘـﺴﮔ
ﯽـﻣ ﻪـﻤﯿﺑ
ﺪﻧاﻮﺗ ﺎـﺻﻮﺼﺨﻣ نﺎﻣرد ﻪﺑ ﺮﺘﺸﯿﺑ يﺪﻨﺒﯾﺎﭘ و ﯽﻣﺮﮕﻟد ﺚﻋﺎﺑ
"
ﺪﻧراد ﯽﻟﺎﻣ تﻼﮑﺸﻣ ﻪﮐ يداﺮﻓا رد دﻮﺷ
.
ﺮﮑﺸﺗ و ﯽﻧادرﺪﻗ
ﻦﯾا ﻌﻟﺎﻄﻣ ﻪ قﻼﺧا ﺪﮐ ﺎﺑ
IR.IAU.NAJAFABAD.REC.1399.017
درﻮﻣ ﺪﯿﯾﺄﺗ
.ﺖﻓﺮﮔ راﺮﻗ دﺎﺑآ ﻒﺠﻧ ﺪﺣاو ﯽﻣﻼﺳا دازآ هﺎﮕﺸﻧاد ﻦﯾﺪﺑ ﻪﻠﯿﺳو ﺐﺗاﺮﻣ سﺎﭙﺳ و ﯽﻧادرﺪﻗ دﻮﺧ ار زا ﻪﯿﻠﮐ
ﺮﻣ مﺮﺧ نﺎﺘﺳﺮﻬﺷ ﺖﺷاﺪﻬﺑ ﺰﮐﺮﻣ ﺖﻣﻼﺳ تﺎﻣﺪﺧ ﻊﻣﺎﺟ ﺰﮐا
دﺎﺑآ ﯽﺘﺑﺎﯾد مﺮﺘﺤﻣ نارﺎﻤﯿﺑ ﻪﯿﻠﮐ و ﻪﮐ
ﺎﻣ ار رد مﺎﺠﻧا
ﺶﻫوﮋﭘ
،ﺪﻧدﻮﻤﻧ يرﺎﯾ مﻼﻋا
ﻢﯿﯾﺎﻤﻧ ﯽﻣ
.
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7هرود ،ﻪﺘﻓﺎﯾ 23
، رﺎﻬﺑ 1400 References
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Medication Adherence and its Related Factors in Patients with Type 2 Diabetes
Badrizadeh A1, Rezaii Jamaloi H2*, Khanzadeh M3, Foroughi S4, Saki M5
1. PhD Student in Health Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran
2. Assistant Professor of Health Psychology, Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran, [email protected]
3. Assistant Professor of Psychology, Department of Psychology, Feizoleslam Non - Governmental Non - Profit Institute of Higher Education, Khomeinishahr, Isfahan, Iran
4. Assistant Professor, Department of Nursing, Nursing Faculty of Aligudarz, Lorestan University of Medical Sciences, Aligudarz, Iran
5. Assistant Professor, Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
Received: 26 Sep 2020 Accepted: 29 Dec 2021
Abstract
Background: One of the public health challenges in the worldwide is diabetes, and adherence to treatment is crucial. Adherence to treatment can help reduce the complications of the disease.
Therefore, this study was performed to evaluate the status of adherence to treatment among patients with type 2 diabetes in Khorramabad.
Materials and Methods: In this cross-sectional study, 392 men and women with type 2 diabetes referred to comprehensive health centers in Khorramabad between May and August 2016 were studied. Demographic questionnaire and Morisky Medication Adherence Scale (MMAS-8) were used to collect data. Version 22 SPSS and descriptive analysis were used to analyze the data.
Significance level in the present study was less than 0.05. Descriptive tests, Chi-square, Fisher's exact test, and independent t-test were used.
Results: The mean age of study participants was 56.03 ± 10.91. 68.9% (270 people) were women and 31/1% (122 people) were men. According to the score obtained from the Morisky questionnaire, a total of 219 patients (55/9%) followed the desired treatment and 173 (44/1%) followed the unfavorable treatment. There was a significant relationship between patients' adherence to treatment with the variables of gender, marital status, educational status, and their monthly income. No statistically significant between age and employment status with adherence to treatment were observed.
Conclusion: Findings of this study showed that adherence to treatment among patients with type 2 diabetes in Khorramabad is in a good level. Health policy makers should strive to ensure that all patients adhere to their treatment process with easy access to services and reduced costs.
Keywords: Type 2 diabetes, Adherence to treatment, Morisky Scale, Medication.
*Citation: Badrizadeh A, Rezaii Jamaloi H, Khanzadeh M, Foroughi S, Saki M. Medication Adherence and its Related Factors in Patients with Type 2 Diabetes. Yafte. 2021; 23(2):1-10.
