慢性病老年患者药物依从性的性别认知决定因素
Gender Based Cognitive Determinants Of Medication Adherence In Older Adults With Chronic Conditions.
作者信息
Mahmoodi Hassan, Jalalizad Nahand Fatemah, Shaghaghi Abdolreza, Shooshtari Shahin, Jafarabadi Mohammad Asghari, Allahverdipour Hamid
机构信息
Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Department of Health Education and Health Promotion, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran.
出版信息
Patient Prefer Adherence. 2019 Oct 15;13:1733-1744. doi: 10.2147/PPA.S219193. eCollection 2019.
BACKGROUND
Life course gender-role traits and social stereotypes could affect the pattern of medication adherence in old age.
OBJECTIVES
The main purpose of this study was to investigate gender based cognitive determinants of medication adherence in a sample of older adults who suffer from at least a chronic condition.
METHODS
In this cross-sectional design, 455 older adults participated from five health centers in Tabriz city, Iran from June to August 2017 using a random sampling method. Next, required data about medication adherence, knowledge and beliefs about prescribed medications, perceived self-efficacy in medication adherence, illness perception, and reasons for medication non-adherence were gathered using a structured written questionnaire through face-to-face interviews with the attendees.
RESULTS
Low medication adherence was reported by 54.5% of the study participants. Perceived self-efficacy for medication adherence (OR = 1.04; 95% CI: 1.00, 1.08) and medication adherence reason (OR = 0.96; 95% CI: 0.92, 0.99) were two identified strong predictors of medication adherence among the studied older men. Illness perception (OR = 1.02; 95% CI: 1.00, 1.02) and beliefs toward prescribed medication (OR = 0.95; 95% CI: 0.93, 0.98) were both recognized as the significant predictors of medication adherence in the older women subgroup.
CONCLUSION
Gender based variations were noted regarding the medication adherence in the studied sample and attributes of cognitive function were the main pinpointed elucidating parameters for the non-conformity. The explicit cognitive processes must be considered in care provision or interventional programs that target medication adherence in older adults.
背景
生命历程中的性别角色特征和社会刻板印象可能会影响老年人的药物依从模式。
目的
本研究的主要目的是调查患有至少一种慢性病的老年人群中基于性别的药物依从性认知决定因素。
方法
在这项横断面设计中，2017年6月至8月，采用随机抽样方法，从伊朗大不里士市的五个健康中心招募了455名老年人。接下来，通过与参与者进行面对面访谈，使用结构化书面问卷收集有关药物依从性、对处方药的知识和信念、药物依从性的自我效能感、疾病认知以及药物不依从原因的所需数据。
结果
54.5%的研究参与者报告药物依从性较低。在研究的老年男性中，药物依从性的自我效能感（OR = 1.04；95%CI：1.00，1.08）和药物依从性原因（OR = 0.96；95%CI：0.92，0.99）是两个确定的药物依从性强预测因素。疾病认知（OR = 1.02；95%CI：1.00，1.02）和对处方药的信念（OR = 0.95；95%CI：0.93，0.98）均被认为是老年女性亚组中药物依从性的重要预测因素。
结论
在所研究的样本中，药物依从性存在基于性别的差异，认知功能属性是不符合依从性的主要明确解释参数。在针对老年人药物依从性的护理提供或干预计划中，必须考虑明确的认知过程。
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