儿童炎症性肠病治疗计划的意愿性和意外性不依从：对生活质量和疾病活动相关性的初步调查。

Volitional and accidental nonadherence to pediatric inflammatory bowel disease treatment plans: initial investigation of associations with quality of life and disease activity.

机构信息

Section of Developmental and Behavioral Sciences, Children’s Mercy Hospitals & Clinics, Kansas City, MO 64108, USA.

出版信息

J Pediatr Psychol. 2011 Jan;36(1):116-25. doi: 10.1093/jpepsy/jsq046. Epub 2010 May 23.

DOI:10.1093/jpepsy/jsq046

PMID:20498007

Abstract

OBJECTIVE

To examine rates of volitional and accidental nonadherence, and explore potential differential associations of each with disease activity and quality of life (QOL), in pediatric patients with inflammatory bowel disease (IBD).

METHODS

One hundred families (100 parents, 78 adolescents) recruited from a large Midwestern children's hospital reported on the child's medication nonadherence and QOL. Healthcare providers supplied disease activity ratings.

RESULTS

Most adolescents (73.1%) and parents (70.1%) reported engaging in accidental nonadherence, whereas a smaller group (35 and 30%, respectively) reported engaging in volitional nonadherence to the child's prescribed medication regimen. Frequency of accidental nonadherence was unrelated to disease activity or any specific QOL area examined, whereas greater frequency of volitional nonadherence was associated with greater disease activity and poorer parent reported psychosocial QOL.

CONCLUSIONS

Nonadherence and the relationship with disease severity and QOL may be more complex for children with IBD than understood through previous work.

摘要

目的

研究炎症性肠病（IBD）患儿中自愿性和意外性不依从的发生率，并探讨每种不依从与疾病活动度和生活质量（QOL）的潜在差异关联。

方法

从一家中西部大型儿童医院招募了 100 个家庭（100 位家长，78 位青少年），报告了孩子的药物不依从和 QOL 情况。医疗保健提供者提供了疾病活动度评分。

结果

大多数青少年（73.1%）和家长（70.1%）报告发生了意外性不依从，而较小的比例（分别为 35%和 30%）报告了对孩子规定的药物治疗方案进行了自愿性不依从。意外性不依从的频率与疾病活动度或检查的任何特定 QOL 领域无关，而自愿性不依从的频率越高，疾病活动度越高，父母报告的心理社会 QOL 越差。