Bennett Britney, Sharma Manoj, Bennett Russell, Mawson Anthony R, Buxbaum Sarah G, Sung Jung Hye
Epidemiologist, STD/HIV Office, Mississippi State Department of Health, Jackson, Mississippi.
Department of Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, Mississippi.
J Caring Sci. 2018 Mar 1;7(1):1-8. doi: 10.15171/jcs.2018.001. eCollection 2018 Mar.
Depression is a major public health issue. One of the concerns in depression research and practice pertains to non-compliance to prescribed medications. The purpose of the study was to predict compliance with medication use for patients with depression using social cognitive theory (SCT). Based on this study it was envisaged that recommendations for interventions to enhance compliance for medication use could be developed for patients with depression. The study was conducted using cross sectional design (n=148) in southern United States with a convenience sample of clinic-based depression patients with a 37-item valid and reliable questionnaire. Sample size was calculated to be 148 using G*Power (five predictors with a 0.80 power at the 0.05 alpha level and an estimated effect size of 0.10 with an inflation by 10% for missing data). Social cognitive theory constructs of expectations, self-efficacy and self-efficacy in overcoming barriers, self-control, and environment were reified. Data were analyzed using multiple linear regression and multiple logistic regression analyses. Self-control for taking medication for depression (P=0.04), expectations for taking medication for depression (P=0.025), age (P<0.0001) and race (P=0.04) were significantly related to intent for taking medication for depression (Adjusted R = 0.183). In race, Blacks had lower intent to take medication for depression. Social cognitive theory is weakly predictive with low explained variance for taking medication for depression. It needs to be bolstered by newer theories like integrative model or multi-theory model of health behavior change for designing educational interventions aimed at enhancing compliance to medication for depression.
抑郁症是一个重大的公共卫生问题。抑郁症研究与实践中的一个关注点是患者对处方药的不依从性。本研究的目的是运用社会认知理论(SCT)预测抑郁症患者的药物治疗依从性。基于该研究,设想可为抑郁症患者制定提高药物治疗依从性的干预建议。本研究采用横断面设计(n = 148),在美国南部对以诊所为基础的抑郁症患者进行便利抽样,并使用一份有37个项目的有效且可靠的问卷。使用G*Power计算样本量为148(五个预测变量,在0.05的α水平下功效为0.80,估计效应量为0.10,因缺失数据增加10%)。对社会认知理论中的期望、自我效能、克服障碍的自我效能、自我控制和环境等构念进行了具体化。数据采用多元线性回归和多元逻辑回归分析。抑郁症服药的自我控制(P = 0.04)、抑郁症服药的期望(P = 0.025)、年龄(P < 0.0001)和种族(P = 0.04)与抑郁症服药意愿显著相关(调整后R = 0.183)。在种族方面,黑人服用抑郁症药物的意愿较低。社会认知理论对抑郁症服药的预测能力较弱,解释方差较低。需要通过整合模型或健康行为改变多理论模型等更新的理论来加强,以设计旨在提高抑郁症药物治疗依从性的教育干预措施。