McCormick King Megan L, Mee Laura L, Gutiérrez-Colina Ana M, Eaton Cyd K, Lee Jennifer L, Blount Ronald L
Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, 111 Michigan Ave NW, Suite 3600, Washington, DC 20010, USA.
J Pediatr Psychol. 2014 Apr;39(3):283-93. doi: 10.1093/jpepsy/jst074. Epub 2013 Sep 29.
This study assessed relationships among internalizing symptoms, barriers to medication adherence, and medication adherence in adolescents with solid organ transplants.
The sample included 72 adolescents who had received solid organ transplants. Multiple mediator models were tested via bootstrapping methods.
Bivariate correlations revealed significant relationships between barriers and internalizing symptoms of depression, anxiety, and posttraumatic stress, as well as between internalizing symptoms and medication adherence. Barriers indicative of adaptation to the medication regimen (e.g., forgetting, lack of organization) were related to medication adherence and mediated the relationship between internalizing symptoms and medication adherence.
These findings indicate that barriers may serve as a more specific factor in the relationship between more general, pervasive internalizing symptoms and medication adherence. Results may help guide areas for clinical assessment, and the focus of interventions for adolescent transplant recipients who are experiencing internalizing symptoms and/or who are nonadherent to their medication regimen.
本研究评估了实体器官移植青少年的内化症状、药物依从性障碍与药物依从性之间的关系。
样本包括72名接受实体器官移植的青少年。通过自抽样法测试了多个中介模型。
双变量相关性显示，障碍与抑郁、焦虑和创伤后应激的内化症状之间存在显著关系，内化症状与药物依从性之间也存在显著关系。表明适应药物治疗方案的障碍（如遗忘、缺乏条理）与药物依从性相关，并介导了内化症状与药物依从性之间的关系。
这些发现表明，在更普遍、广泛的内化症状与药物依从性之间的关系中，障碍可能是一个更具体的因素。研究结果可能有助于指导临床评估领域，以及针对有内化症状和/或不遵守药物治疗方案的青少年移植受者的干预重点。
