预测坦桑尼亚艾滋病患者对抗逆转录病毒联合疗法的依从性：扩展的计划行为理论模型检验

Predicting adherence to combination antiretroviral therapy for HIV in Tanzania: A test of an extended theory of planned behaviour model.

作者信息

Banas Kasia, Lyimo Ramsey A, Hospers Harm J, van der Ven Andre, de Bruin Marijn

机构信息

a Health Psychology, Institute of Applied Health Sciences , University of Aberdeen , Aberdeen , UK.

b Department of Psychology , University of Edinburgh , Edinburgh , UK.

出版信息

Psychol Health. 2017 Oct;32(10):1249-1265. doi: 10.1080/08870446.2017.1283037. Epub 2017 Feb 13.

DOI:10.1080/08870446.2017.1283037

PMID:28276745

Abstract

OBJECTIVES

Combination antiretroviral therapy (cART) for HIV is widely available in sub-Saharan Africa. Adherence is crucial to successful treatment. This study aimed to apply an extended theory of planned behaviour (TPB) model to predict objectively measured adherence to cART in Tanzania.

DESIGN

Prospective observational study (n = 158) where patients completed questionnaires on demographics (Month 0), socio-cognitive variables including intentions (Month 1), and action planning and self-regulatory processes hypothesised to mediate the intention-behaviour relationship (Month 3), to predict adherence (Month 5).

MAIN OUTCOME MEASURES

Taking adherence was measured objectively using the Medication Events Monitoring System (MEMS) caps. Model tests were conducted using regression and bootstrap mediation analyses.

RESULTS

Perceived behavioural control (PBC) was positively (β = .767, p < .001, R = 57.5%) associated with adherence intentions. Intentions only exercised an indirect effect on adherence (B = 1.29 [0.297-3.15]) through self-regulatory processes (B = 1.10 [0.131-2.87]). Self-regulatory processes (β = .234, p = .010, R = 14.7%) predicted better adherence.

CONCLUSION

This observational study using an objective behavioural measure, identified PBC as the main driver of adherence intentions. The effect of intentions on adherence was only indirect through self-regulatory processes, which were the main predictor of objectively assessed adherence.

摘要

目的

抗逆转录病毒联合疗法（cART）在撒哈拉以南非洲地区已广泛应用于治疗艾滋病。坚持治疗对于成功治疗至关重要。本研究旨在应用扩展的计划行为理论（TPB）模型来预测坦桑尼亚客观测量的cART治疗依从性。

设计

前瞻性观察性研究（n = 158），患者在第0个月完成关于人口统计学的问卷调查，在第1个月完成包括治疗意愿在内的社会认知变量调查，在第3个月完成假设用于调节意愿与行为关系的行动计划和自我调节过程调查，以预测第5个月的依从性。

主要观察指标

使用药物事件监测系统（MEMS）帽客观测量服药依从性。使用回归分析和引导中介分析进行模型测试。

结果

感知行为控制（PBC）与治疗意愿呈正相关（β = 0.767，p < 0.001，R = 57.5%）。意愿仅通过自我调节过程对依从性产生间接影响（B = 1.29 [0.297 - 3.15]），自我调节过程（B = 1.10 [0.131 - 2.87]）。自我调节过程（β = 0.234，p = 0.010，R = 14.7%）可预测更好的依从性。