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Validation of Psychosocial Factors as Predictors of Medication Adherence among Veterans following Hospitalization for Acute Coronary Syndrome.

机译：心理社会因素作为急性冠脉综合征住院后退伍军人服药依从性的预测因子的验证。

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摘要

The current study was an analysis of a randomized clinical trial of a multifaceted intervention to improve adherence to cardiac medications. This study sought to validate selected psychosocial factors as predictors of medication adherence among veterans hospitalized for an Acute Coronary Syndrome event. The participants in this study were recruited from four Veterans Administration medical centers in the United States. This study was grounded in the Social Cognitive Theory as the basis for exploring the role of medication-taking self-efficacy as a predictor of medication adherence behaviors. The primary psychosocial variables of interest included self-efficacy, depression, cognitive functioning and health literacy. The outcome variable in this study was patient's overall medication adherence to cardioprotective medications prescribed at hospital discharge. This study was guided by a conceptual framework that examined how the separate but interrelated and reciprocally influencing variables of cognitive function, health literacy and depression, impacted self-efficacy which, in turn, was predicted act as a determinant of medication adherence. In this study, self-efficacy was found to be a significant independent predictor of medication adherence. Patients with high self-efficacy had higher odds of being adherent than patients with lower self-efficacy, after controlling for the other predictor variables in the model. Health literacy, depression and cognitive functioning were not found to predict medication adherence in this study. However, considering the prevalence of depression and cognitive impairment within this sample of veterans, future research should examine these psychosocial factors in a larger veteran population and, perhaps, in the population at large. With the knowledge that medication adherence is a multi-dimensional problem, future interventions to improve medication-taking behaviors should integrate existing health behavior models that can provide a framework for isolating recognized triggers of behavior and applying strategies to deal with them in an effort to drive and sustain behavior change. Improving general awareness and enhanced evaluation of patients' personal, behavioral, and environmental factors will enable healthcare providers to make appropriate treatment recommendations that take into consideration based on the specific needs of their patients.
机译：目前的研究是一项针对改善心脏药物依从性的多方面干预措施的随机临床试验分析。这项研究试图验证选定的社会心理因素作为住院急性冠状动脉综合征事件的退伍军人药物依从性的预测因子。这项研究的参与者是从美国的四个退伍军人管理局医疗中心招募的。这项研究以社会认知理论为基础，是探索以服用自我效能作为药物依从性行为预测指标的作用的基础。感兴趣的主要社会心理变量包括自我效能感，抑郁，认知功能和健康素养。该研究的结果变量是患者对出院时处方的心脏保护药物的总体药物依从性。这项研究是在一个概念框架的指导下进行的，该框架检查了认知功能，健康素养和抑郁的独立但相互关联且相互影响的变量如何影响自我效能，而自我效能又被预测为药物依从性的决定因素。在这项研究中，自我效能感是药物依从性的重要独立预测指标。在控制了模型中的其他预测变量之后，具有较高自我效能感的患者比具有较低自我效能感的患者具有更高的依从性。在本研究中，未发现健康素养，抑郁和认知功能可预测药物依从性。但是，考虑到在这个退伍军人样本中抑郁症和认知障碍的患病率，未来的研究应该在较大的退伍军人人群中，也许在整个人口中检查这些社会心理因素。认识到用药依从性是一个多方面的问题，未来改善用药行为的干预措施应整合现有的健康行为模型，该模型可以提供一个框架，用于隔离公认的行为触发因素并运用策略来应对这些行为，以推动并维持行为改变。提高一般意识并增强对患者的个人，行为和环境因素的评估，将使医疗保健提供者能够根据患者的具体需求提出适当的治疗建议。

著录项

  • 作者

    Thorpe, Frances Fiocchi.;

  • 作者单位

    The George Washington University.;

  • 授予单位 The George Washington University.;
  • 学科 Psychology Behavioral.;Health Sciences Public Health.
  • 学位 Dr.P.H.
  • 年度 2015
  • 页码 172 p.
  • 总页数 172
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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