Hatah Ernieda, Lim Kien Ping, Ali Adliah Mohd, Mohamed Shah Noraida, Islahudin Farida
Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Jalan Pahang, Kuala Lumpur, Malaysia.
Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Jalan Pahang, Kuala Lumpur, Malaysia ; Pharmacy Department, Kuala Lumpur General Hospital, Jalan Pahang, Kuala Lumpur, Malaysia.
Patient Prefer Adherence. 2015 Apr 24;9:589-96. doi: 10.2147/PPA.S79477. eCollection 2015.
Social support can positively influence patients' health outcomes through a number of mechanisms, such as increases in patients' adherence to medication. Although there have been studies on the influence of social support on medication adherence, these studies were conducted in Western settings, not in Asian settings where cultural and religious orientations may be different. The objective of this study was to assess the effects of cultural orientation and religiosity on social support and its relation to patients' medication adherence.
This was a cross-sectional study of patients with chronic diseases in two tertiary hospitals in Selangor, Malaysia. Patients who agreed to participate in the study were asked to answer questions in the following areas: 1) perceived group and higher authority cultural orientations; 2) religiosity: organizational and non-organizational religious activities, and intrinsic religiosity; 3) perceived social support; and 4) self-reported medication adherence. Patients' medication adherence was modeled using multiple logistic regressions, and only variables with a P-value of <0.25 were included in the analysis.
A total of 300 patients completed the questionnaire, with the exception of 40 participants who did not complete the cultural orientation question. The mean age of the patients was 57.6±13.5. Group cultural orientation, organizational religious activity, non-organizational religious activity, and intrinsic religiosity demonstrated significant associations with patients' perceived social support (r=0.181, P=0.003; r=0.230, P<0.001; r=0.135, P=0.019; and r=0.156, P=0.007, respectively). In the medication adherence model, only age, duration of treatment, organizational religious activity, and disease type (human immunodeficiency virus) were found to significantly influence patients' adherence to medications (adjusted odds ratio [OR] 1.05, P=0.002; OR 0.99, P=0.025; OR 1.19, P=0.038; and OR 9.08, P<0.05, respectively).
When examining religious practice and cultural orientation, social support was not found to have significant influence on patients' medication adherence. Only age, duration of treatment, organizational religious activity, and disease type (human immunodeficiency virus) had significant influence on patients' adherence.
社会支持可通过多种机制对患者的健康结果产生积极影响，例如提高患者的药物依从性。尽管已有关于社会支持对药物依从性影响的研究，但这些研究是在西方背景下进行的，而非在文化和宗教取向可能不同的亚洲背景下。本研究的目的是评估文化取向和宗教信仰对社会支持的影响及其与患者药物依从性的关系。
这是一项对马来西亚雪兰莪州两家三级医院的慢性病患者进行的横断面研究。同意参与研究的患者被要求回答以下方面的问题：1）感知到的群体和更高权威文化取向；2）宗教信仰：组织性和非组织性宗教活动以及内在宗教信仰；3）感知到的社会支持；4）自我报告的药物依从性。使用多元逻辑回归对患者的药物依从性进行建模，分析中仅纳入P值<0.25的变量。
共有300名患者完成了问卷，40名未完成文化取向问题的参与者除外。患者的平均年龄为57.6±13.5岁。群体文化取向、组织性宗教活动、非组织性宗教活动和内在宗教信仰与患者感知到的社会支持存在显著关联（r分别为0.181，P = 0.003；r = 0.230，P < 0.001；r = 0.135，P = 0.019；r = 0.156，P = 0.007）。在药物依从性模型中，仅发现年龄、治疗时长、组织性宗教活动和疾病类型（人类免疫缺陷病毒）对患者的药物依从性有显著影响（调整后的优势比[OR]分别为1.05，P = 0.002；OR 0.99，P = 0.025；OR 1.19，P = 0.038；OR 9.08，P < 0.05）。
在考察宗教实践和文化取向时，未发现社会支持对患者的药物依从性有显著影响。仅年龄、治疗时长、组织性宗教活动和疾病类型（人类免疫缺陷病毒）对患者的依从性有显著影响。
