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首页> 外文期刊>Journal of Public Health Research >Intentional and unintentional medication non-adherence in hypertension: the role of health literacy, empowerment and medication beliefs
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Intentional and unintentional medication non-adherence in hypertension: the role of health literacy, empowerment and medication beliefs

机译:高血压患者的有意和无意用药不依从:健康素养,赋权和用药观念的作用

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摘要

Background : Medication non-adherence is a major public health issue, creating obstacles to effective treatment of hypertension. Examining the underlying factors of deliberate and non-deliberate non-adherence is crucial to address this problem. Thus, the goal of the present study is to assess the socio-demographic, clinical and psychological determinants of intentional and unintentional non-adherence. Design and methods: A cross-sectional survey was conducted between March, 2015 and April, 2016. The sample consisted of hypertension patients holding at least one medical prescription (N=109). Measurements assessed patients’ medication adherence, health literacy, empowerment, self-efficacy, medication beliefs, and patients’ acceptance of their doctor’s advice, socio-demographic and clinical characteristics. Results : Patients who occasionally engaged in either intentional or unintentional non-adherence reported to have lower adherence selfefficacy, higher medication concern beliefs, lower meaningfulness scores and were less likely to accept the doctor’s treatment recommendations. Patients who occasionally engaged in unintentional nonadherence were younger and had experienced more side effects compared to completely adherent patients. Adherence self-efficacy was a mediator of the effect of health literacy on patients’ medication adherence and acceptance of the doctor’s advice was a covariate. Conclusions : Regarding the research implications, health literacy and adherence self-efficacy should be assessed simultaneously when investigating the factors of non-adherence. Regarding the practical implications, adherence could be increased if physicians i) doublecheck whether their patients accept the treatment advice given and ii) if they address patients’ concerns about medications. These steps could be especially important for patients characterized with lower self-efficacy, as they are more likely to engage in occasional nonadherence.
机译:背景:药物不依从是主要的公共卫生问题,为有效治疗高血压造成了障碍。检查故意和非故意不遵守的根本因素对于解决此问题至关重要。因此,本研究的目的是评估有意和无意非依从性的社会人口统计学,临床和心理决定因素。设计与方法:在2015年3月至2016年4月之间进行了横断面调查。该样本包括至少持有一张医疗处方(N = 109)的高血压患者。测量评估了患者的用药依从性,健康素养,赋权,自我效能,用药信念以及患者对医生建议,社会人口统计学和临床​​特征的接受程度。结果:偶尔进行有意或无意非依从性的患者据报道具有较低的依从性自我效能感,较高的用药关注信念,较低的意义评分,并且不太可能接受医生的治疗建议。与完全依从的患者相比,偶尔进行意外的非依从性的患者更年轻,并且副作用更大。坚持自我效能是健康素养对患者药物依从性影响的中介,而接受医生的建议则是协变量。结论:关于研究意义,在调查不依从性因素时应同时评估健康素养和依从性自我效能。关于实际意义,如果医生i)仔细检查他们的患者是否接受给出的治疗建议,以及ii)如果他们解决了患者对药物的担忧,则依从性可能会增加。这些步骤对于自我效能较低的患者尤其重要,因为他们更有可能偶尔出现不依从的情况。

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