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首页> 外文期刊>The Internet Journal of Academic Physician Assistants >Sleep-Rhythm Disorder And Anarchic Eating Behaviors Impact On Adolescents’ Treatment Compliance
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Sleep-Rhythm Disorder And Anarchic Eating Behaviors Impact On Adolescents’ Treatment Compliance

机译：睡眠节律障碍和无政府饮食行为对青少年治疗依从性的影响

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Purpose: Treatment compliance demands diligence and rhythmicity that not all adolescents are able to assure. Knowing adolescents’ high frequencies of sleep-rhythm disorders and irregular eating habits, we hypothesized that a link exists between perturbed circadian rhythms and medication non-adherence.Methods: This inquiry, with an interviewer-completed questionnaire, included 115 youths 13–20 years old, taking prescribed oral medications and consulting in a unit for adolescents with social, familial and/or school difficulties. An algorithm comprised of four scales evaluating treatment compliance was used. Associations were assessed with univariate and multivariate logistic-regression models.Results: The algorithm classified 30.4% of the participants non-adherent. After adjusting the final model, perturbed sleep rhythms and poor eating habits were significantly and independently associated with treatment non-compliance.Conclusions: Although not all potential confounding factors were taken into account, the strength of the associations retained pleads for further investigations of a larger and more homogeneous population. Introduction The World Health Organization declared: “Improving adherence would have the biggest impact on the health population than any improvement in medical”. Two meta-analyses (1)(2) found campaigns aimed at improving teenagers' adherence inefficient. In specific diseases, such as asthma, numerous studies showed that adherence drops drastically when comparing babies' (77%) (3)(4) and teenagers' (30%)(5), after which rising during adulthood (50 to 60%)(6).Published findings suggest that teenagers are more frequently treatment non-compliant that is to say they don't follow their treatment or do so infrequently. This could be explained by the treatments' daily load of obligations and the teenagers abilities to handle such a task. For many, juggling both treatments and their hectic everyday schedule can result in mismanaging these two departments. Moreover, they don't have the long-term perspective to appreciate a well-followed treatment's advantages. Worsening of the condition, heavy morbidity, rising health-care costs, premature death are some consequences of non-adherence, to name a few.The adolescent chronobiological disorder linked to circadian rhythm sleep and anarchic eating habits reflect their craving to escape parental control to be independent. Furthermore, teenagers and young adults are sensitive to disrupted circadian rhythms. The delayed-sleep–phase disorder affects approximately 7–16% of teenagers (7). In addition to daytime drowsiness (affecting 20–40%), are responsible for a higher rate of scholastic failures, attention problems, more accidents and affective disorders(7). However, no study has considered disturbed sleep cycles impact on treatment adherence. Concomitantly, teenagers' diets have gone from bad to worse since 2000 (8). This, alongside different types of fragmented households other a stereotypical two-parent household, contributes to the lack of limits imposed to them. Snacking has been more and more favoured with premature independence. The sleep-rhythm disorders and anarchic eating habits are markers of opposition to the social classical model (9), reflecting their desire to break free of parental control. Qualitative studies have shown that daily drug intake could be viewed as a restriction to their freedom and a sign of addiction. We supposed that this desire for independence expressed by rhythm disorders could also influence drug compliance.We investigated potential links between treatment compliance and two elementary circadian rhythms (disturbed sleep cycles and poor eating habits). Methods Study design and participantsThis study was conducted in the H?tel-Dieu Hospital Outpatient Department, dedicated to adolescents with social, familial and school difficulties, which provides free access to general practitioner, gynecologist, dermatologist and psychologist consultations. S
机译：目的：治疗依从性要求勤奋和节律，并非所有青少年都能保证。知道青少年的睡眠节律紊乱和不规律的饮食习惯的频率很高，我们假设在昼夜节律紊乱和药物不依从之间存在联系。方法：这项调查问卷是由访调员完成的，包括115位年龄在20至20岁之间的年轻人年纪较大，服用处方药并在有社会，家庭和/或学校困难的青少年中进行咨询。使用了由评估治疗依从性的四个量表组成的算法。用单变量和多变量logistic回归模型对关联进行评估。结果：该算法将30.4％的参与者归为非依从者。调整最终模型后，睡眠节奏紊乱和不良饮食习惯与治疗不依从显着且独立相关。结论：尽管并未考虑所有潜在的混杂因素，但这种依存关系的强度保留了对更大的进一步研究的诉求。和更多的同质人口。引言世界卫生组织宣布：“提高依从性将对健康人口产生最大的影响，而不是改善医学水平。”两项荟萃分析（1）（2）发现，旨在提高青少年的依从性的运动不够有效。在特定疾病中，例如哮喘，大量研究表明，将婴儿（77％）（3）（4）和青少年（30％）（5）进行比较时，依从性急剧下降，此后成年后上升（50％至60％） ）（6）。已发表的研究结果表明，青少年更经常接受不合规的治疗，也就是说，他们不遵循治疗或不经常进行治疗。这可以通过治疗的日常义务负担和青少年处理此类任务的能力来解释。对于许多人来说，兼顾治疗方法和繁忙的日程安排可能会导致这两个部门的管理不善。而且，他们没有长远的眼光去欣赏一个良好遵循的治疗方法的优点。病情恶化，高发病率，医疗保健费用上升，过早死亡是不坚持治疗的一些后果。与生物钟节律性睡眠和无政府饮食习惯相关的青少年计时生物学疾病反映出他们渴望摆脱父母控制独立。此外，青少年和年轻人对昼夜节律的破坏很敏感。延迟睡眠阶段疾病影响约7–16％的青少年（7）。除了白天的嗜睡（影响20％至40％）之外，还有导致学术失效率，注意问题，更多事故和情感障碍的发生率更高的原因（7）。但是，没有研究考虑睡眠周期紊乱对治疗依从性的影响。同时，自2000年以来，青少年的饮食习惯越来越糟（8）。这与不同类型的分散家庭以及其他定型的双亲家庭一起，导致对他们施加限制。零食已越来越受到过早独立的青睐。睡眠节律障碍和无政府饮食习惯是对社会经典模型的反对标志（9），反映了他们摆脱父母控制的愿望。定性研究表明，每日吸毒可被视为限制其自由和成瘾的迹象。我们认为由节奏障碍表达的对独立性的渴望也可能影响药物的依从性。我们调查了治疗依从性与两个基本昼夜节律之间的潜在联系（睡眠周期紊乱和不良饮食习惯）。方法研究设计和参与者这项研究是在H？tel-Dieu医院门诊部进行的，专门为有社会，家庭和学校困难的青少年提供免费的全科医生，妇科医生，皮肤科医生和心理医生咨询。小号

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