Rodrigues Joana Ramos, Faria Daniela Santos, Neves Joana Sousa, Silva Joana, Peixoto Daniela, Alcino Sérgio, Afonso Maria Carmo, Teixeira Filipa, Afonso Rosa Marina, Pereira Henrique, Azevedo Soraia, Costa José Tavares
Unidade Local de Saúde do Alto Minho.
Universidade da Beira Interior (UBI).
Acta Reumatol Port. 2019 Apr-Jun;44(2):132-137.
The study was conducted in order to investigate adherence in patients with Rheumatoid arthritis (RA), correlating it with other variables such as affect and self-esteem. Seventy-eight patients with RA between 20 and 81 years of age were evaluated. Patients were assessed for Medical Outcomes Study (MOS) Measures of Patient Adherence, Rosenberg self-esteem scale and Short Portuguese version of the Positive and Negative Affect Schedule (PANAS). Pearson's correlation coefficient was used to assess the correlation between the therapeutic compliance and age, disease activity, disability, GPA, self-esteem, affect and inflammatory parameters. An independent T-test was used to evaluate differences in adherence within gender. The one-way analysis of variance (ANOVA) was used to determine associations between adherence and marital status, education level and employment status. A linear regression model was adjusted with stepwise data entry to determine predictors of therapeutic compliance. Patients had a mean age of 57 years and disease duration of 12.8 years. We observed higher levels of adherence in patients with higher self-esteem (r= 0.343, p<0.05) and positive affect (r= 0.345, p<0.01). The adjusted linear regression model allowed the identification of positive affect as a RA patient's adherence predictor (R = 0.347, p<0.05). In our study, high levels of self-reported adherence in RA patients were found. Positive affect seems to be an important determinant of therapeutic adherence in RA patients. These results suggest a relevant role of psychosocial aspects in therapeutic compliance and outcome, which should alert physicians to the need of an holistic approach of the patient.
本研究旨在调查类风湿性关节炎（RA）患者的治疗依从性，并将其与情感和自尊等其他变量相关联。对78名年龄在20至81岁之间的RA患者进行了评估。对患者进行了医疗结局研究（MOS）患者依从性测量、罗森伯格自尊量表以及葡萄牙语简短版正负性情绪量表（PANAS）的评估。使用皮尔逊相关系数来评估治疗依从性与年龄、疾病活动度、残疾程度、GPA、自尊、情感和炎症参数之间的相关性。使用独立样本t检验来评估性别之间依从性的差异。使用单因素方差分析（ANOVA）来确定依从性与婚姻状况、教育水平和就业状况之间的关联。通过逐步数据录入调整线性回归模型，以确定治疗依从性的预测因素。患者的平均年龄为57岁，病程为12.8年。我们观察到自尊水平较高（r = 0.343，p<0.05）和具有积极情感（r = 0.345，p<0.01）的患者具有更高的依从性。调整后的线性回归模型确定积极情感为RA患者依从性的预测因素（R = 0.347, p<0.05）。在我们的研究中，发现RA患者自我报告的依从性水平较高。积极情感似乎是RA患者治疗依从性的一个重要决定因素。这些结果表明心理社会因素在治疗依从性和治疗结果中具有重要作用，这应提醒医生需要对患者采取整体治疗方法。
