Huda Al-Noumani, PhD, RN Assistant Professor, Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman. Jia-Rong Wu, PhD, RN Associate Professor, School of Nursing, University of North Carolina at Chapel Hill. Debra Barksdale, PhD, RN, FNP-BC, CNE, FAANP, FAAN Professor, School of Nursing, Virginia Commonwealth University, Richmond. George Knafl, PhD Professor, School of Nursing, University of North Carolina at Chapel Hill. Esra AlKhasawneh, PhD, RN, FAAN Associate Professor, College of Nursing, Sultan Qaboos University, Muscat, Oman. Gwen Sherwood, PhD, RN, FAAN Professor, School of Nursing, University of North Carolina at Chapel Hill.
J Cardiovasc Nurs. 2018 Nov/Dec;33(6):518-526. doi: 10.1097/JCN.0000000000000511.
Patients' health beliefs are essential to improve medication adherence among patients with hypertension.
Our objective was to examine the relationship between (1) patients' beliefs about hypertension, medication, and self-efficacy and medication adherence and (2) medication adherence and blood pressure control in Oman.
This cross-sectional study included 215 participants with hypertension. Participants completed 4 questionnaires (Arabic version) to measure medication adherence, beliefs about hypertension severity, beliefs about medication, and self-efficacy. Bivariate and multivariate logistic regression was used to conduct the analyses.
Higher self-efficacy (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.54-4.37), stronger beliefs about medication necessity (OR, 1.98; 95% CI, 1.21-3.23), increased age (OR, 1.06; 95% CI, 1.03-1.10), and fewer medication concerns (OR, 0.34; 95% CI, 0.20-0.57) were related to high medication adherence. Moreover, uncontrolled blood pressure was less likely in participants with high medication adherence (OR, 0.47; 95% CI, 0.24-0.93).
Patients' beliefs are important consideration to improve medication adherence. Clinically, patients' beliefs should be assessed, and strategies to improve medication adherence should incorporate beliefs as a key component to improve antihypertensive medication adherence. Patient education and counseling regarding hypertension and necessity and side effects of medications are important to maximize positive beliefs and improve medication adherence.
患者的健康信念对于提高高血压患者的药物依从性至关重要。
我们的目的是检验（1）患者对高血压、药物和自我效能的信念与药物依从性之间的关系，以及（2）在阿曼，药物依从性与血压控制之间的关系。
这项横断面研究纳入了 215 名高血压患者。参与者完成了 4 份问卷（阿拉伯语版），以测量药物依从性、对高血压严重程度的信念、对药物的信念和自我效能。采用二变量和多变量逻辑回归进行分析。
更高的自我效能（比值比 [OR]，2.59；95%置信区间 [CI]，1.54-4.37）、更强的药物必要性信念（OR，1.98；95% CI，1.21-3.23）、年龄增长（OR，1.06；95% CI，1.03-1.10）和较少的药物顾虑（OR，0.34；95% CI，0.20-0.57）与较高的药物依从性相关。此外，药物依从性高的患者血压控制不佳的可能性较低（OR，0.47；95% CI，0.24-0.93）。
患者的信念是提高药物依从性的重要考虑因素。临床上，应评估患者的信念，并且提高药物依从性的策略应将信念作为改善降压药物依从性的关键组成部分。对高血压以及药物的必要性和副作用进行患者教育和咨询对于最大限度地提高积极信念和改善药物依从性非常重要。
