Sint Maartenskliniek, Nijmegen, The Netherlands.
Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, The Netherlands.
Arthritis Care Res (Hoboken). 2021 Mar;73(3):364-373. doi: 10.1002/acr.24186.
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.
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.
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.
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.
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。
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。
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。
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。
