McCullough Amanda R, Tunney Michael M, Elborn J Stuart, Bradley Judy M, Hughes Carmel M
Clinical & Practice Research Group, School of Pharmacy, Queen's University Belfast, Belfast, UK.
Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Health Expect. 2015 Dec;18(6):2477-88. doi: 10.1111/hex.12217. Epub 2014 Jun 20.
Adherence to treatment is low in bronchiectasis and is associated with poorer health outcomes. Factors affecting adherence decisions have not been explored in patients with bronchiectasis.
We aimed to explore patients' perspectives on adherence, factors affecting adherence decision making and to develop a conceptual model explaining this decision-making process in adults with bronchiectasis.
Adults with bronchiectasis participated in one-to-one semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analysed independently by two researchers using thematic analysis. Data from core themes were extracted, categorized into factors affecting adherence decision making and used to develop the conceptual model.
Participants' beliefs about treatment, the practical aspects of managing treatment, their trust in health-care professionals and acceptance of disease and treatment were important aspects of treatment adherence. The conceptual model demonstrated that adherence decisions were influenced by participants' individual balance of barriers and motivating factors (treatment-related, disease-related, health-care-related, personal and social factors).
Adherence decision-making in bronchiectasis is complex, but there is the potential to enhance adherence by understanding patients' specific barriers and motivators to adherence and using this to tailor adherence strategies to individual patients and treatments.
支气管扩张症患者的治疗依从性较低，且与较差的健康结局相关。支气管扩张症患者中影响依从性决策的因素尚未得到探讨。
我们旨在探究患者对依从性的看法、影响依从性决策的因素，并建立一个概念模型来解释成年支气管扩张症患者的这一决策过程。
成年支气管扩张症患者参与一对一的半结构化访谈。访谈进行录音，逐字转录，并由两名研究人员使用主题分析法独立分析。从核心主题中提取数据，归类为影响依从性决策的因素，并用于建立概念模型。
患者对治疗的信念、治疗管理的实际方面、对医护人员的信任以及对疾病和治疗的接受程度是治疗依从性的重要方面。概念模型表明，依从性决策受患者个体障碍与激励因素（治疗相关、疾病相关、医护相关、个人和社会因素）平衡的影响。
支气管扩张症的依从性决策很复杂，但通过了解患者依从性的具体障碍和激励因素，并据此为个体患者和治疗制定依从性策略，有可能提高依从性。
