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疾病认知、药物信念和 D 型人格与甲状腺癌幸存者的药物依从性有关吗?基于人群的 PROFILES 注册研究。

Are illness perceptions, beliefs about medicines and Type D personality associated with medication adherence among thyroid cancer survivors? A study from the population-based PROFILES registry.

机构信息

Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.

Comprehensive Cancer Centre the Netherlands (CCCN), Eindhoven Cancer Registry, Eindhoven, The Netherlands.

出版信息

Psychol Health. 2020 Feb;35(2):128-143. doi: 10.1080/08870446.2019.1619730. Epub 2019 May 25.

Abstract

To examine self-reported medication adherence and its association with illness perceptions, beliefs about medication and personality among thyroid cancer survivors. Individuals diagnosed with thyroid cancer between 1990 and 2008, as registered in the Eindhoven Cancer Registry, received our survey; 86% ( = 306) responded. Many patients reported that they never forgot taking their medicines ( = 168; 56%), never altered the dose ( = 258; 88%), never stopped taking them ( = 291; 99%), never decided to miss a dose ( = 284; 97%) and never took less than instructed ( = 286; 97%). Fifty-two percent were classified as nonadherent; of which 14% intentional nonadherent only, 70% were nonintentional nonadherent only and 16% were both intentional and nonintentional nonadherent. Nonadherers were younger, more highly educated, more often employed, had a lower stage at diagnosis, and less often reported ≥2 comorbid conditions than adherers. Furthermore, their illness affected them more emotionally and they more often reported that their life would be impossible without their medicine. Logistic regression models showed that higher age, lower education and lower perceived necessity of medication was associated with better adherence while beliefs about medication, illness perceptions, and personality were not associated with adherence. Despite lifelong dependence on supplement therapy, 52% of thyroid cancer survivors were nonadherent.

摘要

调查甲状腺癌幸存者报告的用药依从性及其与疾病认知、用药信念和人格的关系。1990 年至 2008 年间在埃因霍温癌症登记处登记诊断为甲状腺癌的个体收到了我们的调查;86%( = 306)做出了回应。许多患者报告说他们从未忘记服药( = 168;56%)、从未改变剂量( = 258;88%)、从未停止服药( = 291;99%)、从未决定漏服( = 284;97%)且从未少于医嘱剂量服药( = 286;97%)。52%的患者被归类为不依从;其中 14%为故意不依从,70%为非故意不依从,16%为既故意又非故意不依从。不依从者更年轻、受教育程度更高、更多就业、诊断时分期更低,且报告≥2 种合并症的比例低于依从者。此外,他们的疾病对他们的情绪影响更大,他们更经常报告如果没有药物,他们的生活将无法继续。逻辑回归模型显示,年龄较大、教育程度较低和感知到的药物必要性较低与更好的依从性相关,而对药物的信念、疾病认知和人格与依从性无关。尽管需要终生依赖补充治疗,但 52%的甲状腺癌幸存者不依从。

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