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CF 患者服药依从性决定因素与父母精神性的关系。

Relationship of adherence determinants and parental spirituality in cystic fibrosis.

机构信息

Division of Pulmonary Medicine and Department of Pastoral Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.

出版信息

Pediatr Pulmonol. 2012 Jun;47(6):558-66. doi: 10.1002/ppul.21614. Epub 2011 Dec 13.

Abstract

The course of cystic fibrosis (CF) progression in children is affected by parent adherence to treatment plans. The Theory of Reasoned Action (TRA) posits that intentions are the best behavioral predictors and that intentions reasonably follow from beliefs ("determinants"). Determinants are affected by multiple "background factors," including spirituality. This study's purpose was to understand whether two parental adherence determinants (attitude towards treatment and self-efficacy) were associated with spirituality (religious coping and sanctification of the body). We hypothesized that parents' attitudes toward treatment adherence are associated with these spiritual constructs. A convenience sample of parents of children with CF aged 3-12 years (n = 28) participated by completing surveys of adherence and spirituality during a regular outpatient clinic visit. Type and degree of religious coping was examined using principal component analysis. Adherence measures were compared based on religious coping styles and sanctification of the body using unpaired t-tests. Collaborative religious coping was associated with higher self-efficacy for completing airway clearance (M = 1070.8; SD = 35.8; P = 0.012), for completing aerosolized medication administration (M = 1077.1; SD = 37.4; P = 0.018), and for attitude towards treatment utility (M = 38.8; SD = 2.36; P = 0.038). Parents who attributed sacred qualities to their child's body (e.g., "blessed" or "miraculous") had higher mean scores for self-efficacy (airway clearance, M = 1058.6; SD = 37.7; P = 0.023; aerosols M = 1070.8; SD = 41.6; P = 0.020). Parents for whom God was manifested in their child's body (e.g., "My child's body is created in God's image") had higher mean scores for self-efficacy for airway clearance (M = 1056.4; SD = 59.0; P = 0.039), aerosolized medications (M = 1068.8; SD = 42.6; P = 0.033) and treatment utility (M = 38.8; SD = 2.4; P = 0.025). Spiritual constructs show promising significance and are currently undervalued in chronic disease management.

摘要

囊性纤维化 (CF) 患儿的病程受家长对治疗方案的坚持程度影响。理性行为理论 (TRA) 认为,意图是最好的行为预测指标,而意图则合理地来自于信念(“决定因素”)。决定因素受多种“背景因素”影响,包括精神信仰。本研究旨在了解父母对治疗的坚持的两个决定因素(对治疗的态度和自我效能)是否与精神信仰(宗教应对和身体神圣化)相关。我们假设父母对治疗坚持的态度与这些精神信仰有关。我们招募了 28 名年龄在 3-12 岁之间的 CF 患儿的父母参与研究,这些父母在常规门诊就诊期间完成了关于治疗坚持和精神信仰的调查问卷。使用主成分分析检查宗教应对的类型和程度。使用独立样本 t 检验比较不同宗教应对方式和身体神圣化对治疗坚持度的影响。合作型宗教应对与更高的气道廓清(M=1070.8;SD=35.8;P=0.012)、雾化药物治疗(M=1077.1;SD=37.4;P=0.018)和对治疗有用性的自我效能(M=38.8;SD=2.36;P=0.038)相关。将孩子的身体归因于神圣属性(例如“受祝福的”或“奇迹般的”)的父母,其自我效能感得分更高(气道廓清,M=1058.6;SD=37.7;P=0.023;雾化药物治疗,M=1070.8;SD=41.6;P=0.020)。认为神在孩子身体上显现的父母(例如“我孩子的身体是上帝创造的形象”),其气道廓清(M=1056.4;SD=59.0;P=0.039)、雾化药物治疗(M=1068.8;SD=42.6;P=0.033)和治疗有用性(M=38.8;SD=2.4;P=0.025)的自我效能感得分更高。精神信仰具有显著意义,但目前在慢性病管理中未得到充分重视。

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