University of Missouri, Columbia, MO, USA.
Psychooncology. 2017 Dec;26(12):2294-2299. doi: 10.1002/pon.4362. Epub 2017 Jan 30.
Despite the efficacy of clinical treatments (eg, adjuvant hormonal therapy) for breast cancer survivors (BCS), nonadherence rates remain high, increasing the risk of recurrence and mortality. The current study tested a theoretical model of medical nonadherence that proposes depression to be the most proximal predictor of medical nonadherence among BCS.
Breast cancer survivors were recruited from radiation clinics in Missouri. Survey data were collected 12 months after the end of primary treatment. The sample size included 133 BCS.
Findings show substantial support for the model, demonstrating that depression mediated the relation between physical symptoms, cognitive symptoms, social support, and adherence to medication. This finding was replicated with a measure of mood disturbance.
These findings support the prediction that medication nonadherence among BCS multiply determined process and have compelling implications for healthcare providers and interventions designed to increase medication adherence among BCS.
尽管乳腺癌幸存者（BCS）的临床治疗（例如辅助激素治疗）有效，但仍存在较高的不依从率，这增加了复发和死亡的风险。本研究测试了一个关于医学不依从的理论模型，该模型提出抑郁是 BCS 中医疗不依从的最接近的预测因素。
从密苏里州的放射诊所招募了乳腺癌幸存者。在主要治疗结束后 12 个月收集了调查数据。样本包括 133 名 BCS。
研究结果充分支持该模型，表明抑郁在身体症状、认知症状、社会支持和对药物的依从性之间的关系中起中介作用。使用情绪障碍的衡量标准复制了这一发现。
这些发现支持了这样一种预测，即 BCS 的药物依从性是一个多因素决定的过程，这对医疗保健提供者和旨在提高 BCS 药物依从性的干预措施具有重要意义。
