Son Youn-Jung, Won Mi Hwa
Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.
College of Nursing, Dankook University, Cheonan, Korea.
Int J Nurs Pract. 2017 Jun;23(3). doi: 10.1111/ijn.12525. Epub 2017 Feb 13.
Many studies have reported the negative effects of depression on adherence to antihypertensive medication. However, little is known about the mechanism underlying this relationship in elderly patients with hypertension. The aim of this cross-sectional study is to examine the mediating role of self-efficacy in the relationship between depression and medication adherence among older patients with hypertension. The data were collected from October to December 2014. A total of 255 older patients with hypertension were assessed using the Geriatric Depression Scale, the Self-efficacy for Appropriate Medication Use Scale, and the Morisky Medication Adherence Scale. Hierarchical linear regression analysis and the Sobel test were used to examine the mediating role of self-efficacy in the relationship between depression and medication adherence. Depression and self-efficacy were statistically significant predictors of medication adherence in older patients with hypertension. Self-efficacy partially mediated the relationship between depression and medication adherence. Interventions targeting self-efficacy could increase the confidence of patients in their ability to actively take their medicines. Moreover, health care providers should be aware of the importance of early detection of depression in older patients with hypertension. Future studies with longitudinal data are warranted to clarify the multidirectional relationships between depression, self-efficacy, and medication adherence.
许多研究报告了抑郁症对降压药物依从性的负面影响。然而,对于老年高血压患者中这种关系的潜在机制知之甚少。这项横断面研究的目的是检验自我效能在老年高血压患者抑郁症与药物依从性之间关系中的中介作用。数据收集于2014年10月至12月。共有255名老年高血压患者使用老年抑郁量表、合理用药自我效能量表和Morisky药物依从性量表进行评估。采用分层线性回归分析和Sobel检验来检验自我效能在抑郁症与药物依从性之间关系中的中介作用。抑郁症和自我效能是老年高血压患者药物依从性的统计学显著预测因素。自我效能部分介导了抑郁症与药物依从性之间的关系。针对自我效能的干预措施可以增强患者积极服药的信心。此外,医疗保健提供者应意识到早期发现老年高血压患者抑郁症的重要性。有必要进行未来的纵向数据研究,以阐明抑郁症、自我效能和药物依从性之间的多向关系。