Schoenthaler Antoinette, Ogedegbe Gbenga, Allegrante John P
Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY 10027, USA.
Health Educ Behav. 2009 Feb;36(1):127-37. doi: 10.1177/1090198107309459. Epub 2007 Dec 12.
Many studies have documented the negative effects of depression on adherence to recommended treatment; however, little is known about the mechanism underlying this relationship. Using the Kenny and Baron analytic framework of mediation, the authors assessed whether self-efficacy mediated the relationship between depression and medication adherence in 167 hypertensive African Americans followed in a primary care practice. Depressive symptoms are associated with poor medication adherence (beta=.013, p=.036) and low self-efficacy (beta=-.008, p=.023). Self-efficacy is negatively associated with medication adherence at follow-up (beta=-.612, p<.001). The relationship between depressive symptoms and medication adherence becomes nonsignificant when controlling for self-efficacy (beta=.010, p=.087). Implications for further examination into the mediating role of self-efficacy and the deleterious effect of depression on medication adherence are discussed.
许多研究记录了抑郁症对遵循推荐治疗的负面影响；然而，对于这种关系背后的机制知之甚少。作者采用肯尼和巴伦的中介分析框架，评估自我效能感是否在167名接受初级保健的非洲裔美国高血压患者中，介导了抑郁症与药物依从性之间的关系。抑郁症状与较差的药物依从性（β = 0.013，p = 0.036）和较低的自我效能感（β = -0.008，p = 0.023）相关。在随访中，自我效能感与药物依从性呈负相关（β = -0.612，p < 0.001）。在控制自我效能感后，抑郁症状与药物依从性之间的关系变得不显著（β = 0.010，p = 0.087）。本文讨论了进一步研究自我效能感的中介作用以及抑郁症对药物依从性的有害影响的意义。
