Department of Social Work, University of Michigan Health System, Ann Arbor, MI, USA.
Epilepsy Behav. 2013 Apr;27(1):59-63. doi: 10.1016/j.yebeh.2012.11.047. Epub 2013 Jan 31.
Treatment adherence is often suboptimal among adolescents with epilepsy. However, knowledge is lacking regarding factors that affect adherence. Empirical studies and theories of human development suggest that self-management skills, self-efficacy, and sense of control are related to adherence. Eighty-eight adolescents with epilepsy, and their parents, completed standardized measures assessing epilepsy knowledge and expectations, treatment self-management, sense of control, and self-efficacy. Better self-reported parent adherence was correlated with greater epilepsy knowledge/expectations (p<0.001) and more medications (p = 0.042). Better self-reported adolescent adherence was correlated with fewer siblings (p = 0.003) and higher adolescent epilepsy knowledge/expectations (p<0.001). Greater adolescent epilepsy knowledge/expectations correlated with parent self-reported adherence (p<0.001), Powerful others locus of control (p = 0.008), and adolescent/parent discordance regarding epilepsy knowledge/expectations (p<0.001). Interventions that enhance adolescent's knowledge of epilepsy and their treatment plan, while ensuring that teens and parents are in agreement with regard to epilepsy treatment, might contribute to better adherence.
青少年癫痫患者的治疗依从性往往不理想。然而，对于影响依从性的因素知之甚少。实证研究和人类发展理论表明，自我管理技能、自我效能感和控制感与依从性有关。88 名癫痫青少年及其父母完成了标准化的评估量表，包括癫痫知识和期望、治疗自我管理、控制感和自我效能感。父母自我报告的更好的依从性与更高的癫痫知识/期望（p<0.001）和更多的药物（p = 0.042）相关。青少年自我报告的更好的依从性与兄弟姐妹较少（p = 0.003）和青少年癫痫知识/期望更高（p<0.001）相关。青少年癫痫知识/期望越高，与父母自我报告的依从性（p<0.001）、强大他人的控制点（p = 0.008）以及青少年/父母在癫痫知识/期望方面的不一致性（p<0.001）相关。增强青少年对癫痫及其治疗计划的认识，同时确保青少年和父母在癫痫治疗方面达成一致，可能有助于提高依从性。
