Shope J T
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor 48109-0201.
Epilepsy Res Suppl. 1988;1:23-47.
Adherence to prescribed medication, or patient compliance, was studied over a period of several years in 3 populations with seizure disorders: 2 pediatric (n = 90, n = 211), and 1 adult population (n = 177). Compliance was assessed in several different ways: self-reports and serum levels analyzed for the level/dose ratio as well as the coefficient of variation for each patient. Correlates studied included Health Belief Model variables as well as internal locus of control, social support, knowledge about seizures and other variables. The assessed extent of compliance ranged from 54% to 82% in the various groups. Overall, compliance was related to motivation, value of illness threat reduction, and probability that compliant behavior will reduce the threat. Also related to compliance were some measures of the following types of variables: demographic, structural, attitudinal, provider/patient interaction, social support, experience with the regimen, internal control, and knowledge. A group discussion intervention designed to enhance compliance was implemented and evaluated effectively in the pediatric seizure population. In the adult population, compliance and seizure control both increased over a 2 year follow-up period, but were not significantly related.
在3个患有癫痫症的人群中,对遵医嘱服药情况(即患者依从性)进行了为期数年的研究:2个儿科人群(n = 90,n = 211)和1个成人群体(n = 177)。通过几种不同方式评估依从性:自我报告以及分析血清水平以得出水平/剂量比以及每位患者的变异系数。所研究的相关因素包括健康信念模型变量以及内控点、社会支持、癫痫知识和其他变量。在各个组中,评估的依从程度在54%至82%之间。总体而言,依从性与动机、疾病威胁降低的价值以及依从行为降低威胁的可能性有关。与依从性相关的还有以下几类变量的一些指标:人口统计学、结构、态度、医护人员/患者互动、社会支持、治疗方案体验、内部控制和知识。在儿科癫痫人群中实施并有效评估了一项旨在提高依从性的小组讨论干预措施。在成人群体中,在2年的随访期内,依从性和癫痫控制情况均有所改善,但两者之间无显著关联。