神经外科重症患者家属心理症状群及其影响因素分析

目的 探讨神经外科重症监护室(NICU)患者家属心理症状群及其影响因素,为缓解NICU重症患者家属心理症状提供参考.方法 采用便利抽样法,选取190例在NICU住院患者的家属应用简明心境量表(BPOMS-SF)、简易应对方式问卷(SCSQ)进行问卷调查,分析症状群及其与应对方式的关系.结果 在被调查的30个症状中发生率排在前五位的依次是焦虑、担忧、孤弱无助、困惑、不确定感.经过探索性因子分析,30个症状可归为四个症状群:紧张-焦虑症状群(担忧、紧张、焦虑、不安,)、精力不足症状群(疲倦、疲惫不堪、疲乏、无精打采、精疲力竭)、信息缺乏症状群(不确定感、困扰、孤弱无助,慌张)、怨恨症状群(生气、恼火、有怨气).应对方式、患者与家属的关系、格拉斯哥昏迷评分以及家属文化程度是心理症状群的影响因素(P<0.05).结论 神经外科NICU患者家属心理症状群种类多且复杂,应对方式等因素对其有着重要影响,临床医护人员在关注患者的同时关注患者家属的心理症状,教会家属积极应对方式,减轻心理困扰.     

肺癌手术患者出院期间症状群的调查研究

目的 调查肺癌手术患者出院期间的症状从而确定肺癌患者出院期间的症状群.方法 采用随机抽取的方法选取三级甲等专科医院胸外科肺癌手术患者100例,采用安德森症状评估量表及修订版的肺癌特异症状模块对其进行调查,对患者的一般资料、症状及症状干扰采用描述性分析,采用探索性因子分析,主成分提取法,提取因子载荷≥0.5的症状纳入症状...     

量身订制慢性心衰患者自我管理干预措施的效果研究

目的 评价慢性心衰患者实施个体化自我管理干预措施对提高心衰患者自我管理能力的效果.方法 采用随机对照研究的方法,将2014年1月至12月65例心衰患者按住院号随机分为研究组和对照组,运用“中文版欧洲心力衰竭自我护理量表”评估患者自我管理能力,研究组根据问卷及约谈中的不足量身制定个体化的自我管理方案,对照组患者采用常规方法进行自我管理.干预前及干预后6个月通过调查问卷分别评估两组患者自我管理能力.结果 干预6个月后,干预组患者自我管理能力问卷评分与对照组比较显著降低[(21.52±3.45) vs.(32.42±6.58)],差异有统计学意义(P＜0.05),而且干预组再次心衰复发入院率低(6.25％)、持续服药率高(90.62％).结论 慢性心衰患者症状管理的自我效能还有待提高;量身制定个体化的自我管理干预措施可以提高心率衰竭患者对症状管理的自我效能.     

食管癌病人术后 3个月的症状群及相关因素研究

目的 探讨食管癌病人术后3个月所经历的症状群,并分析症状群与生活质量的相关性.方法 选取2017年6月至2019年2月在南通大学附属如皋医院胸外科手术的食管癌病人102例纳入研究.采用人口统计学和疾病特征问卷、中文版安德森症状评估量表(MDASI)、癌症治疗功能评价量表(FACT-G)、中文版心理弹性量表(CD-RISC)评估病人术后3个月症状发生情况和生活质量.采用探索性因子分析提取症状群;采用logistic回归和Pearson相关分析确定病人症状群预测因素及其与生活质量的关系.结果 有2例中途退出,最终共有100例病人全程参与.术后3个月病人最常见的四种症状是疲劳(63.0％),反流(51.0％),睡眠不安(47.0％)和食欲不振(45.0％),病人四大严重症状分别是疲劳(4.97±3.18)分,食欲不振(4.19±2.67)分,睡眠不安(4.08±2.75)分和反流(3.72±3.07)分.由此确定了4个症状群:吞咽困难-心理,放化疗不良反应,消化道重建和疲劳-睡眠.性别、食管癌分期和心理弹性水平是影响吞咽困难-心理症状群的重要因素(均P<0.05).性别、食管癌分期、心理弹性水平和手术+术后辅助放化疗是影响放化疗不良反应和疲劳-睡眠症状群的重要因素(均P<0.05).性别、食管癌分期、心理弹性水平和吻合位置是影响消化道重建症状群的重要因素(均P<0.05).前述4个症状群与生活质量之间具有显著的相关性(r=-0.499、-0.436、-0.311、-0.379,均P<0.05),其中吞咽困难-心理症状群相关性最大(r=-0.499,P<0.001).结论 应关注食管癌病人术后3个月的4个症状群:吞咽困难-心理,放化疗不良反应,消化道重建和疲劳-睡眠,在术后3个月应重视食管癌病人的症状管理.根据影响因素,包括性别,食管癌分期,心理弹性水平,手术或手术+术后辅助放化疗和吻合位置,实施个体化干预.     

我国苯丙胺类兴奋剂和K粉滥用人群用药后症状及戒断症状分析

目的:了解目前我国苯丙胺类兴奋剂(ATS)和K粉(主要成分为氯胺酮)滥用的基本情况及滥用后出现的症状、体征/行为和戒断症状的特点。方法:采用自拟调查问卷从2010年3月-2010年12月对北京、上海、云南、广东、湖南和湖北等地的强制隔离戒毒所或社区内的以滥用甲基苯丙胺(MA)、"摇头丸"(MDMA)、K粉或者"麻谷丸"为主的合成毒品滥用者进行回顾性调查,并统计分析人口学特征、合成毒品滥用情况、成瘾性、用药后的症状、体征/行为和戒断症状。结果:共调查1459名滥用者,男性占65.17%,平均年龄为(32.87±8.78)岁。将调查对象按主要滥用毒品种类分为三组:ATS(滥用主要毒品包括MA或MDMA或"麻谷丸")的有1191人(83.93%),K粉的有141人(9.94%),混用ATS+K粉的有87人(6.13%)。通过因子分析将用药后出现的症状、体征/行为归为6组症状群。有98.21%(1318/1342)的合成毒品滥用者出现了一定的用药后症状、体征/行为;兴奋症状在三组滥用人群中均最为严重,其中ATS和ATS+K粉前三位症状为失眠、兴奋和欣快,K粉为欣快、兴奋和失眠;第二位症状群在ATS和K粉中均为躯体症状,而ATS+K粉则为精神病性症状;且ATS+K粉的兴奋症状、精神病性症状,躯体症状和行为紊乱比ATS和K粉者严重。有90.88%(1215/1337)合成毒品滥用者停药后出现了一定的戒断症状,常出现的是用药渴求、困倦、疲乏无力、嗜睡、注意力不集中等。用药渴求在K粉和ATS+K粉中最为严重(排序第1位),在ATS中排名第4位,ATS中最为严重的戒断症状是困倦。结论:目前我国ATS和K粉的滥用状况具有不同的特点,并且用药后的症状和戒断症状在滥用ATS、K粉及混用两者的人群中存在差异,应根据各自特点制定相关的预防措施和治疗手段。     

PDCA循环管理对改善老年晚期肺癌化疗患者的临床症状及其对继发感染的影响

目的:探究PDCA循环管理对改善老年晚期肺癌化疗患者的临床症状及其对继发感染的影响。方法:选取2016年10月—2018年7月期间医院收治的老年晚期肺癌化疗患者60例资料,按管理干预方式的不同将其随机分为对照组和观察组(每组30例);对照组患者给予采用常规管理干预治疗,观察组患者给予采用PDCA循环管理干预治疗,比较两组患者分别干预治疗后临床症状(体温持续时间)复常时间和抗菌药物使用时间,以及治疗后继发感染发生率的差异。结果:观察组患者干预治疗后临床症状(体温热持续时间)复常时间早于对照组(P<0.05),抗菌药物使用时间均短于对照组(P<0.05),而继发感染的发生率低于对照组(P<0.05)。结论:PDCA循环管理干预治疗有效改善了老年晚期肺癌化疗患者的症状,减少继发感染的发生。     

β受体阻滞剂在52例慢性心力衰竭中的应用

心脏病晚期常合并慢性心力衰竭(下称心衰),传统的治疗方法如应用洋地黄制剂、利尿剂及血管扩张剂等,虽然在短期内能够显著改善患者症状,但是患者因心衰恶化的住院率及死亡率仍然较高。众多的大规模临床试验证实β受体阻滞剂治疗心衰可以改善左室功能,提高患者的生活质量,减少住     

晚期肿瘤患者的常见急诊症状及治疗措施

目的:综合分析晚期肿瘤患者的常见急诊症状及救治措施,为治疗晚期肿瘤患者提供科学的数据参考。方法:采取回顾性研究方法,选取在我院急诊科2015年1月-2016年12月收治的因为急性症状就诊的晚期肿瘤患者临床资料143例作为研究对象。采用SPSS20.0统计学软件进行统计学分析143例晚期肿瘤患者的基本资料、针对性的救治措施以及成功抢救率、死亡率。结果:晚期肿瘤急诊措施一般包括以下几种:(1)呼吸机辅助呼吸;(2)抗感染;(3)营养支持;(4)心电监护;(5)深静脉置管等;常见急诊症状为:(1)发热;(2)出血;(3)呼吸困难;(4)癌痛;(5)恶病质综合征等;抢救成功率为79.72%(114/143),抢救失败率为20.28%(29/143)。结论:晚期肿瘤患者的常见急诊症状为发热、出血、呼吸困难、癌痛以及恶病质综合征等,对晚期肿瘤患者采取积极的综合救治措施能够显著提高生存率。     

鼻咽癌患者同步放化疗期间症状群的变化研究

目的　探讨鼻咽癌患者在同步放化疗的不同时期各症状群的评分变化，及不同时期评分变化的相关性，为延续性症状管理提供依据。方法　本研究为前瞻性研究。采用记忆症状评估量表（MSAS）、医学应对方式问卷（MCMQ）、欧洲癌症研究与治疗组织生命质量核心量表（EORTC QLQ-C30）、病史问卷（MHQ）及主观全面评定（SGA）5种问卷评价，选取2020年1月至2021年12月在广州市番禺区中心医院肿瘤科进行同步放化疗的80例鼻咽癌患者，其中男60例，女20例，年龄（48.43±11.80）岁，对同步放化疗的不同时期［治疗前（T1）、治疗第14天（T2）、治疗第28天（T3）、治疗结束当天（T4）、治疗结束后1个月（T5）］各种症状群发生的频率、强度等进行评分，并根据患者在同步放化疗的不同时期及临床分期（Ⅰ和Ⅱ期为早期组，Ⅲ期为中期组，Ⅳ期为晚期组）进行分组，采用重复测量方差分析、单向方差分析及Pearson相关性分析评估5种问卷评分的变化情况及其相关性。结果　MSAS、EORTC QLQ-C30、MHQ及SGA的评分在不同时间点间比较差异均有统计学意义（MSAS：F=109.295，P<0.001；EORTC QLQ-C30：F=3.526，P=0.019；MHQ：F=195.156，P<0.001；SGA：F=82.605，P<0.001）。多个症状群评分不同时间点间均存在显著相关性（MSAS症状群T1比T2、T1比T3、T2比T3、T2比T4、T3比T4、T3比T5、T4比T5：均P<0.05；MCMQ症状群T3比T4、T4比T5：均P<0.001；EORTC QLQ-C30症状群T1比T2、T3比T4、T3比T5、T4比T5：均P<0.001；MHQ症状群T1比T4、T2比T3、T2比T4、T3比T4、T3比T5、T4比T5：均P<0.05；SGA症状群T2比T3、T2比T4、T3比T4：均P<0.05）。结论　鼻咽癌患者同步放化疗期间症状群随着治疗的不同时间点其症状是显著变化的，并存在时间相关性，临床上可对患者进行症状管理，并根据症状群动态变化实施个体化干预，在减轻患者症状的同时，提高患者的生存期及生活质量。     

社区精神发育迟滞患者出现精神病性症状的分析

目的探讨社区精神发育迟滞患者出现精神病性症状的临床特点。方法将湖北宜昌市13个区县市划分为中心城区、城郊结合区和远郊区3类。运用分层整群随机抽样方法,在3类城区中各随机抽取1个城区作为样本区,分别为西陵、夷陵、当阳三个区。总共入组540例精神发育迟滞患者,采用目前通用的阳性和阴性综合征量表(PANSS)进行评分,对确诊的精神发育迟滞及其知情者进行访谈,调查患者近1周以来出现的精神病性症状。结果 450例精神发育迟滞中127例(28.2%)至少出现1种精神病性症状。精神病性症状:情感迟钝66例(14.7%),刻板思维45例(10.0%),被动/淡漠社会退缩41例(9.1%),紧张34例(7.6%),冲动控制障碍28例(6.2%),妄想19(4.2%),幻觉行为17例(3.8%);127例患者中患者中PANSS总分30~59分者24人(18.9%),占总精神发育迟滞患者的5.3%;PANSS总分≥60分86例(67.7%),占总精神发育迟滞患者的22.9%;需要紧急临床干预者PANSS总分≥90分17例(13.4%),占总精神发育迟滞患者的3.8%。逐步回归分析,PANSS总分与ADL评分(t=5.45,P<0.01)呈正相关,与WAIC评分呈负相关(t=-5.33,P<0.01)。结论宜昌市社区精神发育迟滞患者总体精神病性症状较轻,需要紧急住院治疗精神发育迟滞患者只占到13.4%。70%以上社区精神发育迟滞患者并不存在精神病性症状。     

疾病感知在中晚期宫颈癌同步放化疗患者症状群与生活质量间的中介效应分析

目的 分析中晚期宫颈癌同步放化疗患者症状群以及疾病感知在症状群与生活质量间的中介效应。方法 纳入2020年4月—2021年4月于我院肿瘤科进行同步放化疗的157例中晚期宫颈癌患者为研究对象,采用中晚期宫颈癌同步放化疗患者症状评估量表、宫颈癌生活质量评价量表（FACT-Cx）、简易疾病感知问卷（BIPQ）动态分析同步放化疗第2疗程完成（T1）、同步放化疗第4疗程完成（T2）、同步放化疗结束后3个月随访时（T3）患者的症状群、生活质量及疾病感知水平;采用Pearson相关系数分析疾病感知与症状群、生活质量的相关性;运用中介效应模型分析疾病感知在症状群与生活质量间的中介效应。结果 157例中晚期宫颈癌患者中,有139例完成随访和调查评估;疲劳在中晚期宫颈癌同步放化疗患者不同时间点的严重程度均排名首位;Pearson相关性分析显示,中晚期宫颈癌同步放化疗患者疾病感知评分与生活质量呈负相关（P<0.05）,与症状群评分呈正相关（P<0.05）;中介效应分析显示,不同时间点的疾病感知在症状群及生活质量间均发挥部分中介效应。结论 同步放化疗中晚期宫颈癌患者不同时间点的症状群存在差异,且在同步放化疗的不同阶段,疾病感知均在症状群与生活质量间发挥中介效应。     

医用自交联透明质酸钠凝胶在鼻窦炎术后填充中的效果观察

目的 观察在鼻窦功能性手术后使用医用自交联透明质酸钠凝胶行鼻腔填塞后的效果.方法 本研究采用自身对照、随机、前瞻性、第三方盲评的方法,选择24例鼻窦炎患者,按Lund-mackay系统评分双侧鼻窦相等,手术由同一医师完成,按随机表决定术腔填塞材料(观察侧选用医用自交联透明质酸钠凝胶填塞,对照侧填充羟甲基纤维素);填充材料对记录者设盲,记录术后3d患者鼻面部不适程度;1周后开始鼻腔冲洗,出院后1、2、4、8及12周复查,复查时不采用医学干预,分别记录鼻腔鼻窦黏膜形态,行Lund-Kennedy鼻内镜评分,进行统计分析.结果 24例鼻窦炎患者,使用医用自交联透明质酸钠凝胶填充侧的不适程度明显低于对照侧;医用自交联透明质酸钠凝胶填充鼻腔鼻窦侧上皮化时间明显缩短,术后1、2、4周鼻内镜下黏膜形态明显优于对照组(P＜0.05),术后8、12周两组比较差异有统计学意义(P＞0.05).结论 医用自交联透明质酸钠凝胶能明显减轻患者术后鼻腔填塞不适感;能促进鼻腔、鼻窦黏膜上皮功能恢复,缩短黏膜上皮化过程,减少术腔水肿、囊泡、痂皮形成及黏膜粘连,更有利于鼻腔鼻窦术后功能恢复.     

Variation in patients' and pharmacists' attribution of symptoms and the relationship to patients' concern beliefs in medications

BackgroundThe process by which symptoms are identified and characterized is related to adverse drug event reporting. Patient and pharmacist symptom attribution may differ and be related to certain patient characteristics.Objectives(1) To compare attribution of symptoms to a cause for patients and pharmacists; (2) to quantify the association between patients' concern beliefs and patient-pharmacist agreement on patients' symptom attribution to medications; and (3) to identify any associations between patients' propensity to agree with pharmacists' assessments of symptom attribution with various clinical and/or sociodemographic characteristics.MethodsAn Internet survey of Medicare beneficiaries was administered by Harris Interactive^®. The survey elicited information on health symptoms that subjects experienced and to whom they reported these symptoms. If subjects did not experience symptoms and did not report them, the reasons for not reporting were elicited. A clinical expert panel reported ratings about respondents' (1) likelihood of the symptom experienced being attributed to a medication and (2) probability of the symptom being attributed to the reason the patient stated. Frequencies of unreported symptoms for each reason/category were examined. Chi-square and Fisher's exact test analyses examined the variations between patients' and pharmacists' ratings of symptom attribution to medications and associations between attribution and patient sociodemographic and clinical characteristics, such as the number of medications used. Independent sample t tests examined how attributions were related to concern beliefs.ResultsMost patients thought their symptom(s) were the result of their disease, something other than medications or age. There was no statistically significant difference between patients' and pharmacists' symptom attribution (χ² = 1.376, P = .24). Individuals whose symptom attributions differed from pharmacists were likely to have stronger concern beliefs in medication (t = ?3.03, P < .01).ConclusionsPatients' concern about their medications may be related to their symptom attributions. Older adults may not consider these concerns when asked about their symptom attributions.     

运动疗法配合心理辅导改善卵巢早衰患者心理及生活质量的效果

目的 探究运动疗法配合心理辅导改善卵巢早衰患者心理及生活质量的效果.方法 选取本院2015年5月至2017年2月收治的110例卵巢早衰患者作为研究对象,采取随机数字表法将患者分为观察组(55例)与对照组(55例).对照组实施临床常规药物治疗,观察组在对照组治疗基础上联合运动疗法及心理辅导.对比两组治疗前后症状积分、两组治疗后性激素水平、两组治护满意度,并采取SCL-90症状自评量表评估患者心理状况改善情况.结果 观察组治疗后症状积分为(7.42±3.21)分,低于对照组的(12.35±3.11)分,且患者性激素水平显著优于对照组;观察组SCL-90症状自评量表总分为(130.53±32.16)分,显著低于对照组的(148.52±40.25)分;均P＜0.05.观察组满意率高达98.18％,高于对照组的83.64％,差异具有统计学意义(P＜0.05).结论 运动疗法及心理辅导在卵巢早衰患者中的应用价值极高,患者症状改善,性激素水平恢复正常,心理状态改善,满意度高,值得推广应用.     

Pain depression and sleep disorders among methadone maintenance treatment patients

Background

The success of rehabilitation is not influenced solely by drug abstinence, but also by the state of general health and well-being, which for patients in methadone maintenance treatment (MMT) frequently is compromised by experiencing pain, depression and sleep disorders. Accordingly, this study sought to (1) characterize clusters of MMT patients who experienced different levels of these symptoms and (2) examine the association between these clusters and quality of life (QOL) measures.

Methods

A convenience sample of MMT patients (n = 73) completed surveys containing four scales (Numeric Rating Scale on Pain, Center for Epidemiological Studies—Depression Scale, General Sleep Disturbance Scale, and Short Form-36 QOL). Homogenous clusters based on the symptom severity of pain, depression and sleep disturbances were created using a two-stage process of: hierarchical clustering and K-means cluster analysis.

Results

Based on the levels of symptoms, MMT patients were grouped as High (n = 29), Moderate (n = 26) or Low (n = 18) symptom cluster members. The High symptom cluster group reported the highest severity levels of pain, depression and sleep disorders. Also, this group had the lowest scores on all QOL indices (p < 0.05). Although pain, depression and sleep disorders effectively distinguish symptom clusters of MMT patients, pain was the single most important symptom differentiating MMT patients.

Conclusions

Successful rehabilitation will necessitate interventions that target MMT patients with high levels of pain, depression and sleep disorders. To the best of our knowledge this study was innovative in its approach to identify the presence of this high risk group by using cluster methodology in the MMT population.     

家属护理干预对糖尿病视网膜病变眼底荧光血管造影患者的影响

目的 探究采用家属护理干预对于糖尿病视网膜病变眼底荧光血管造影患者舒适度及不良反应的护理效果.方法 选择本院2014年12月至2016年10月收治的接受眼底荧光血管造影检查的糖尿病视网膜病变患者104例,随机分为对照组与观察组,各52例.对照组行常规护理,观察组行家属护理干预.对比两组护理后眼底荧光血管造影舒适度及生活质量评分状况,并且分析两组不良反应发生率.结果 观察组舒适度状况优于对照组,观察组无不适感比例为50.00％,高于对照组的26.92％,差异有统计学意义(P＜0.05);观察组晕厥、造影剂过敏以及胃肠道反应发生率分别为0.00％、0.00％及1.92％,低于对照组的9.62％、13.46％及15.38％,差异有统计学意义(均P＜0.05).观察组远视力、移动及光感、调节能力、日常生活能力、读和精细工作以及生活质量总评分分别为(27.98±4.43)分、(12.54±3.06)分、(14.96±5.03)分、(18.65±3.73)分及(73.25±16.21)分,均高于对照组,差异有统计学意义(均P＜ 0.05).结论 对采用眼底荧光血管造影检查的糖尿病视网膜病变患者给予家属护理干预可有效缓解患者不舒适状况,降低不良反应发生率,并且可提高患者生活质量.     

The relationship of patients' cognitive status and therapists' ratings of psychological distress among psychoactive substance users in long-term residential treatment

Patients in a long-term residential substance abuse treatment program (N = 168) were asked to complete the Symptom Checklist-90-Revised (SCL-90-R), a brief inventory that measures psychological distress in nine symptom areas. Using the Symptom Checklist-90 Analogue (SCL-90 Analogue), which allows raters to assess patients along the same dimensions measured by the SCL-90-R, therapists also estimated the degree of psychological distress they observed in their patients. Significantly larger discrepancies were found between therapists' ratings of their patients and patients' ratings of themselves when patients were cognitively impaired (N = 57) than when patients did not display these decrements (N = 111). Furthermore, these patient-therapist assessment differences were negatively related to measures of patients' participation in treatment and length of stay in the program. Clinical and research implications of these findings are discussed.     

Empirically derived symptom sub-groups correspond poorly with diagnostic criteria for functional dyspepsia and irritable bowel syndrome. A factor and cluster analysis of a patient sample

AIM: To determine how clusters (groups) of patients with respect to symptoms compare with a clinical diagnosis in patients with irritable bowel syndrome and non-ulcer dyspepsia. METHODS: All patients who attended a gastroenterology practice at Nepean Hospital were included in the study. All patients received the previously validated Bowel Disease Questionnaire, and were independently assessed by the gastroenterologist. Factor analysis and a k-means cluster analysis were completed. RESULTS: The study population comprised 897 patients [320 males (36%) and 577 females (64%)]. Factor analysis identified nine symptom factors: (1) diarrhoea; (2) constipation; (3) dysmotility; (4) dyspepsia/reflux; (5) nausea/vomiting; (6) bowel; (7) meal-related pain; (8) weight loss; and (9) abdominal pain. A k-means cluster analysis identified seven distinct subject groups, which included an undifferentiated group: (1) diarrhoea; (2) meal-related pain; (3) abdominal pain; (4) faecal indicators; (5) nausea/vomiting/weight loss; and (6) constipation. The majority of irritable bowel syndrome patients fitted into two cluster groups [diarrhoea (25%) and constipation (20%)], whereas those with non-ulcer dyspepsia predominantly fitted into the undifferentiated cluster (34%) and the nausea/vomiting cluster (18%). CONCLUSION: This study supports the concept of symptom subgroups, including the subdivision of patients into diarrhoea- and constipation-predominant irritable bowel syndrome.     

Clusters of non-adherence to medication in neurological patients

BackgroundNon-adherence to medication is a common and serious problem in health care. To develop more effective interventions to improve adherence, there is a need for a better understanding of the individual types of non-adherence.ObjectiveTo determine clusters of non-adherence in neurological patients using a complex adherence questionnaire.MethodsIn this observational, monocentric study 500 neurological patients (consecutive sampling) were recruited in the Department of Neurology at the Jena University Hospital, Germany (outpatient clinic, wards) over a period of 5 months. Patients with severe dementia or delirium who were unable to complete the questionnaire were excluded. Due to missing adherence data, in total, 429 patients with common neurological disorders were analyzed. Different types and clusters of non-adherence using the German Stendal Adherence to Medication Score (SAMS) were determined.ResultsFor the 429 patients, the mean age was 63 years (SD = 16), 189 were female. According to the SAMS total score 74 (17.2%) were fully adherent, 252 (58.7%) showed moderate non-adherence and 103 (24%) showed clinically significant non-adherence. Principal component analysis with Varimax rotation revealed three independent factors explaining 60.5% of the SAMS variance. The bulk of non-adherence was attributed to modifications of medication (41.7%) and forgetting to take the medication (33.2%) followed by lack of knowledge 25.1% about reasons, dosages and time of administration for the medication.ConclusionsIntentional non-adherence was the primary self-reported behavior identified among non-adherent neurological participants. Many patients modified their prescribed medication due to various reasons, such as side effects or lacking effect. Different clusters require different interventions. While for the cluster ´forgetfulness' the reduction of poly-medication and a behavioral approach with reminders seems reasonable, patients in cluster ´missing knowledge' and cluster ´modifications' may need an educational approach.