Cottrell William Neil, Denaro Charles P, Emmerton Lynne
School of Pharmacy, University of Queensland, Brisbane, Qld, Australia.
Patient Prefer Adherence. 2013;7:141-50. doi: 10.2147/PPA.S40725. Epub 2013 Feb 18.
Beliefs about medicines impact on adherence, but eliciting core beliefs about medicines in individual patients is difficult. One method that has the potential to elicit individual core beliefs is the "repertory grid technique." This study utilized the repertory grid technique to elicit individuals' beliefs about their heart failure treatment and to investigate whether generated constructs were different between adherent and nonadherent patients.
Ninety-two patients with heart failure were interviewed using a structured questionnaire that applied the repertory grid technique. Patients were asked to compare and contrast their medicines and self-care activities for their heart failure. This lead to the generation of individual constructs (perceptions towards medicines), and from these, beliefs were elicited about their heart failure treatment, resulting in the generation of a repertory grid. Adherence was measured using the Medication Adherence Report Scale (MARS). Patients with a MARS score ≥ 23 were categorized as "adherent" and those with a score ≤ 22 as "nonadherent." The generated grids were analyzed descriptively and constructs from all grids themed and the frequency of these constructs compared between adherent and nonadherent patients.
Individual grids provided insight into the different beliefs that patients held about their heart failure treatment. The themed constructs "related to water," "affect the heart," "related to weight," and "benefit to the heart" occurred more frequently in adherent patients compared with nonadherent patients.
The repertory grid technique elicited beliefs of individual participants about the treatment of their heart failure. Constructs from self-reported adherent patients were more likely to reflect that their medicines and self-care activities were related to water and weight, and affect and benefit to the heart. Providing clinicians with better insight into individuals' beliefs about their treatment may facilitate the development of tailored interventions to improve adherence.
关于药物的信念会影响依从性，但在个体患者中引出关于药物的核心信念很困难。一种有可能引出个体核心信念的方法是“ repertory grid技术”。本研究利用repertory grid技术引出个体对其心力衰竭治疗的信念，并调查依从性和非依从性患者之间产生的构念是否不同。
使用应用了repertory grid技术的结构化问卷对92名心力衰竭患者进行访谈。要求患者比较和对比他们治疗心力衰竭的药物和自我护理活动。这导致了个体构念（对药物的认知）的产生，并由此引出了他们对心力衰竭治疗的信念，从而产生了一个repertory grid。使用药物依从性报告量表（MARS）测量依从性。MARS评分≥23的患者被归类为“依从性”，评分≤22的患者被归类为“非依从性”。对生成的网格进行描述性分析，对所有网格的主题构念进行分类，并比较依从性和非依从性患者之间这些构念的频率。
个体网格提供了对患者对其心力衰竭治疗持有的不同信念的洞察。与非依从性患者相比，“与水有关”、“影响心脏”、“与体重有关”和“对心脏有益”等主题构念在依从性患者中出现的频率更高。
repertory grid技术引出了个体参与者对其心力衰竭治疗的信念。自我报告的依从性患者的构念更有可能反映出他们的药物和自我护理活动与水和体重有关，并且对心脏有影响和益处。为临床医生提供对个体治疗信念的更好洞察可能有助于制定量身定制的干预措施以提高依从性。
