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医护人员对传统疾病修正型抗风湿药物的内隐和外显态度与其患者的态度有关吗?

Are Health Care Professionals' Implicit and Explicit Attitudes Toward Conventional Disease-Modifying Antirheumatic Drugs Associated With Those of Their Patients?

机构信息

Sint Maartenskliniek, Nijmegen, The Netherlands.

Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands.

出版信息

Arthritis Care Res (Hoboken). 2021 Mar;73(3):364-373. doi: 10.1002/acr.24186.

Abstract

OBJECTIVE

It is generally unknown how the attitudes and beliefs of health care professionals (HCPs) might affect the attitudes, beliefs, and medication-taking behavior of patients with rheumatoid arthritis (RA). This study aims 1) to examine the attitudes, health-related associations (both implicit and explicit), and beliefs of HCPs about conventional disease-modifying antirheumatic drugs, and 2) to assess whether these attitudes, health-related associations, and beliefs of HCPs are associated with those of their patients, with their patients' medication-taking behavior, and disease activity.

METHODS

HCPs were recruited from 2 centers that specialized in rheumatology across The Netherlands, and patient recruitment followed. In this observational study, implicit outcomes were measured with single-category implicit association tests, whereas explicit outcomes were measured with a bipolar evaluative adjective scale and the Beliefs About Medicines Questionnaire-Specific. Spearman's rank correlations were used to describe correlations between implicit and explicit measures of the attitudes of HCPs. Multilevel, mixed-effects linear models were used to examine the association of HCP-related characteristics, including the implicit and explicit outcomes of HCPs, with those of their patients, their medication-taking behaviors, and disease activity.

RESULTS

Of the 1,659 initially invited patients, 254 patients with RA (mean age 62.8 years, mean disease duration 11.8 years, and 68.1% of the patients were female) who were treated by 26 different HCPs agreed to participate in this study. The characteristics, attitudes, health-related associations, and beliefs about medicines of HCPs were not significantly associated with those of their patients, nor with their medication-taking behaviors or disease activity scores.

CONCLUSION

This study demonstrated that the attitudes, health-related associations (as measured both implicitly and explicitly), and beliefs of HCPs were not significantly associated with the attitudes, beliefs, medication-taking behavior, and disease activity of patients with RA.

摘要

目的

医护人员的态度和信念如何影响类风湿关节炎(RA)患者的态度、信念和用药行为,目前尚不清楚。本研究旨在:1)检查医护人员对传统疾病修正抗风湿药物的态度、与健康相关的关联(包括内隐和外显关联)和信念;2)评估医护人员的这些态度、与健康相关的关联和信念是否与患者的态度、信念、用药行为和疾病活动度相关。

方法

从荷兰两家专门从事风湿病学的中心招募医护人员,并进行了患者招募。在这项观察性研究中,使用单类别内隐联想测验测量内隐结果,使用两极评价形容词量表和药物信念问卷特异性测量外显结果。使用 Spearman 等级相关系数描述医护人员态度的内隐和外显测量之间的相关性。使用多级混合效应线性模型来检验与医护人员相关的特征(包括医护人员的内隐和外显结果)与患者的特征、他们的用药行为和疾病活动度之间的关联。

结果

在最初邀请的 1659 名患者中,254 名 RA 患者(平均年龄 62.8 岁,平均病程 11.8 年,68.1%的患者为女性)和 26 名不同的医护人员同意参与这项研究。医护人员的特征、态度、与健康相关的关联和对药物的信念与患者的特征、他们的用药行为或疾病活动评分均无显著相关性。

结论

本研究表明,医护人员的态度、与健康相关的关联(包括内隐和外显测量)和信念与 RA 患者的态度、信念、用药行为和疾病活动度无显著相关性。

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