目的：本研究為瞭解高血壓患者的服藥遵從性不甚理想之影響因素，藉由三元效能
信念模式探討病人的自我效能、他人效能對關係品質的影響，亦釐清關係品質、病
人參與及服藥遵從性之關係；進一步檢視關係品質與病人參與的中介效果。
方法：本研究採橫斷式研究設計，以南部某醫學中心臟血管科高血壓病人與醫師為
研究對象，共計 220 份有效配對問卷；採用 PLS-SEM 瞭解服藥遵從性的預測因子
及檢測中介效果。
結果：病人對醫師能力所產生的他人效能正向影響其知覺醫病之關係品質，關係品
質亦能提升病人向醫師分享疾病相關資訊與討論病情等參與行為，進而影響服藥遵
從性。關係品質在他人效能與病人參與具有部分中介效果；病人參與亦在關係品質
與服藥遵從性具有部分中介效果。
結論：醫師欲提升服藥遵從性，應強化病人知覺醫師能力的信心程度，以增進關係
品質，提升病人參與程度。

Objectives: The purpose of this study was to investigate the factors of suboptimal
medication adherence in patients with hypertension. This study employs the concept
of self-efficacy and other-efficacy in a tripartite efficacy model to examine the factors
for relationship quality, analyze the association between relationship quality, patient
participation and medication adherence, and validate the mediating effect of relationship
quality and patient participation.
Methods: This cross-sectional study collected 220 valid questionnaires from outpatients
with hypertension of the cardiovascular department at a medical center in southern
Taiwan. The data was analyzed using the partial least squares method.
Results: Empirical results confirmed that other-efficacy affect relationship quality,
relationship quality affects patient participation, and patient participation affects
medication adherence. In addition, relationship quality showed partial mediating effects
between other-efficacy and patient participation, whereas patient participation showed
partial mediating effects between relationship quality and medication adherence.
Conclusions: We recommend that physicians draft medication adherence strategies
that increase other-efficacy in medical professionals. These measures may improve
relationship quality between physicians and patients, and participation behavior in
patients.