Conn Kelly M, Halterman Jill S, Lynch Kathleen, Cabana Michael D
Department of Pediatrics, University of Rochester School of Medicine and Dentistry and the Golisano Children's Hospital at Strong, Rochester, New York 14642, USA.
Pediatrics. 2007 Sep;120(3):e521-6. doi: 10.1542/peds.2006-3023.
Previous studies suggest a relationship between parental beliefs about asthma medications and medication adherence. It is not clear how parents' positive and negative feelings about medications interact to influence medication adherence.
The objectives of this study were to describe parents' perceived need for and concerns about their child's asthma medications and to assess the weighted impact of these positive and negative beliefs on parent-reported adherence.
We conducted a cross-sectional survey of parents of children with asthma in southeast Michigan; response rate was 71%. Children with reported use of a preventive asthma medication were included (n = 622). We used a validated Beliefs About Medications Questionnaire (2 subscales: necessity and concern) to assess parents' positive and negative attitudes about their child's medications. To measure how parents weigh these beliefs, we also calculated a necessity-concern differential score (difference between necessity and concern subscales). We used a 4-item parent-report scale to measure medication adherence.
The majority of children were nonminority. Overall, 72% of parents felt that their child's asthma medications were necessary, and 30% had strong concerns about the medications. For 77% of parents, necessity scores were higher than concern scores, and for 17%, concern exceeded necessity. Nonminority parents were more likely to have necessity scores exceed concern scores compared with minority parents (79% vs 68%). Mean adherence scores increased as the necessity-concern differential increased. In a multivariate mixed-model regression, a greater necessity-concern differential score and being nonminority predicted better adherence.
These findings confirm a relationship between medication beliefs and adherence among parents of children with asthma. A better understanding of parents' medication beliefs and their impact on adherence may help clinicians counsel effectively to promote adherence.
先前的研究表明，父母对哮喘药物的看法与药物依从性之间存在关联。目前尚不清楚父母对药物的积极和消极情绪如何相互作用以影响药物依从性。
本研究的目的是描述父母对其孩子哮喘药物的感知需求和担忧，并评估这些积极和消极信念对父母报告的依从性的加权影响。
我们对密歇根州东南部患有哮喘儿童的父母进行了一项横断面调查；回复率为71%。纳入报告使用预防性哮喘药物的儿童（n = 622）。我们使用经过验证的《药物信念问卷》（2个分量表：必要性和担忧）来评估父母对其孩子药物的积极和消极态度。为了衡量父母如何权衡这些信念，我们还计算了必要性-担忧差异分数（必要性和担忧分量表之间的差异）。我们使用一个4项父母报告量表来衡量药物依从性。
大多数儿童为非少数族裔。总体而言，72%的父母认为他们孩子的哮喘药物是必要的，30%的父母对这些药物有强烈担忧。77%的父母，必要性得分高于担忧得分，17%的父母，担忧超过必要性。与少数族裔父母相比，非少数族裔父母更有可能必要性得分超过担忧得分（79%对68%）。随着必要性-担忧差异的增加，平均依从性得分升高。在多变量混合模型回归中，更大的必要性-担忧差异分数和非少数族裔身份预示着更好的依从性。
这些发现证实了哮喘儿童父母的药物信念与依从性之间的关系。更好地理解父母的药物信念及其对依从性的影响可能有助于临床医生进行有效的咨询以促进依从性。
