Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA.
J Pediatr Psychol. 2010 Oct;35(9):1028-37. doi: 10.1093/jpepsy/jsq015. Epub 2010 Mar 18.
Although cross-sectional studies have demonstrated poor adherence to airway clearance therapy (ACT) for patients with cystic fibrosis (CF), no studies have identified longitudinal patterns of adherence. The objective was to characterize and identify predictors of ACT adherence trajectories for individuals with CF.
Secondary data analyses were conducted for a randomized clinical trial examining differences in three ACTs. Participants (n = 153; M = 14.3 years, 55% male, 86% Caucasian, baseline FEV(1)% predicted: M = 86.7)/primary caregivers completed Daily Phone Diaries, an empirically supported adherence measure, every 4 months.
Group-based trajectory modeling revealed the best-fitting solution was a three-group model: low-adherence (14%), medium-adherence (49%), and high-adherence (37%) groups. ACT type was the only significant predictor of adherence trajectories.
Three trajectories of adherence to ACT for patients with CF were found. With the identification of trajectories, adherence interventions can be targeted for the subgroup at highest risk in order to prevent poor health outcomes.
尽管横断面研究表明囊性纤维化（CF）患者的气道清除治疗（ACT）依从性较差，但尚无研究确定依从性的纵向模式。本研究旨在描述并确定 CF 患者 ACT 依从性轨迹的预测因素。
对一项比较三种 ACT 的随机临床试验的二次数据分析。参与者（n = 153；M = 14.3 岁，55%为男性，86%为白种人，基线 FEV1%预计值：M = 86.7）/主要照顾者每 4 个月完成一次每日电话日记，这是一种经过实证支持的依从性测量方法。
基于群组的轨迹建模显示，最佳拟合解决方案是三群组模型：低依从性（14%）、中依从性（49%）和高依从性（37%）群组。ACT 类型是唯一显著预测依从性轨迹的因素。
发现了 CF 患者 ACT 依从性的三种轨迹。通过轨迹的识别，可以针对风险最高的亚组进行依从性干预，以预防不良健康结果。
