Department of Psychology, Astley Ainslie Hospital, Edinburgh, UK.
Psychol Health. 2010 Jun;25(5):601-15. doi: 10.1080/08870440902783610.
The objective was to identify the degree to which illness perceptions and medication beliefs explain variations in reported adherence to medication prescribed for the treatment of non-malignant chronic pain and to test the applicability of an extended version of the self-regulatory model to the chronic pain population. A cross-sectional design included 217 clinic patients completing validated questionnaires assessing their illness perceptions, medication beliefs and reported adherence to medication. Perceptions of illness (pain) as chronic, uncontrollable and unremitting were associated with greater adherence, fewer medication concerns and a belief that treatment was necessary. Structural equation modelling supports an extended SRM for chronic pain. It suggests that patients holding perceptions of serious consequences of pain and high emotion levels have more concerns about medication and are less adherent. Perceptions of serious illness consequences are also associated with stronger beliefs about the necessity of medicines and greater adherence. Beliefs about illness and medication are associated with adherence to treatment in chronic pain and this can be explained by an extended SRM. Results are preliminary and require replication. Further studies should explore the role that emotion has on coping strategies in chronic pain. Interventions should focus on altering unhelpful beliefs that reduce adherence.
目的是确定疾病认知和药物信念在多大程度上可以解释非恶性慢性疼痛治疗药物的报告依从性的差异，并检验自我调节模型的扩展版本在慢性疼痛人群中的适用性。采用横断面设计，纳入 217 名门诊患者，完成评估疾病认知、药物信念和药物报告依从性的验证问卷。将疾病（疼痛）认知为慢性、不可控和持续存在与更高的依从性、更少的药物担忧以及对治疗必要性的信念相关。结构方程模型支持慢性疼痛的扩展 SRM。它表明，对疼痛的严重后果和高情绪水平持有的患者对药物有更多的担忧，依从性较差。对严重疾病后果的认知也与对药物必要性的更强信念和更高的依从性相关。对疾病和药物的信念与慢性疼痛的治疗依从性相关，这可以用扩展的 SRM 来解释。结果是初步的，需要复制。进一步的研究应探讨情绪在慢性疼痛中的应对策略中的作用。干预措施应侧重于改变降低依从性的无益信念。
