School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Cancer Registry, Providence Saint Joseph Medical Center, 501 S Buena Vista St, Burbank, CA, 91505, USA.
BMC Public Health. 2020 Sep 4;20(1):1350. doi: 10.1186/s12889-020-09425-7.
Self-medication by older adults has been always a public health concern. The present study aimed to modify the psychological constructs of Health Belief Model (HBM) in relation to self-medication behaviors using Freire's Adult Education Model (FAEM) among older adults in Khorramabad, Iran, from 2017 to 2018.
The mean age of the older adults was 66.28 ± 7.18 years. This was a randomized controlled trial study conducted on 132 individuals older than 60 who were referred from different health care centers. The participants were selected using multistage sampling method and randomly divided into two groups of intervention and control. The data collection instruments included a questionnaire which was designed based on both HBM and self-medication behaviors questionnaire. The phase of adult education model (AEM) was used to modify the psychological constructs of HBM and self-medication behaviors. Data were analyzed using SPSS software version 20 with a significant level of 0.05. Descriptive statistical tests, chi-squared test, paired t-test, independent t-test, and univariate modeling were employed for the purpose of analyzing data.
There was no significant difference between groups in terms of self-medication. Unawareness of the effects of medicine were the most important reason for self-medication (p = 0.50). The two groups were not significantly different in terms of knowledge, HBM constructs, and self-medication behaviors (p > 0.05). However, they came up to be considerably different for the above variables after the intervention was implemented (p < 0.05). When the findings were adjusted for the effects of confounding variables, there were significant differences between the two groups in almost all constructs of HBM and their behaviors (p < 0.05). However, the perceived barrier modality of HBM did not reach to a significant level of difference between two groups.
The educational intervention, which was based on Freire's AEM, had positive effects on the constructs of HBM and consequently on self-medication behaviors. The psychological constructs of HBM were affected at the phases of listening to problems. Self-medication was tempered at the action-reflection phase with shared creation and evaluation of the action plan geared toward the achievement of the behavioral objectives. The results might be of importance to healthcare professionals involved in care of older patients.
Current Controlled Trials IRCT2013091814512N2. Registered on January 2 - prospectively registered, the trial was registered in the Iranian Clinical Trials Registry http://www.irct.ir .
老年人的自我用药一直是一个公共卫生关注点。本研究旨在 2017 年至 2018 年期间，使用 Freire 的成人教育模型（FAEM）修改与老年人自我用药行为相关的健康信念模型（HBM）的心理结构，地点在伊朗霍拉马巴德。
老年人的平均年龄为 66.28±7.18 岁。这是一项随机对照试验研究，共纳入了 132 名年龄在 60 岁以上的个体，他们均来自不同的医疗保健中心。采用多阶段抽样法选取参与者，并随机分为干预组和对照组。数据收集工具包括基于 HBM 和自我用药行为问卷设计的问卷。采用成人教育模型（AEM）阶段修改 HBM 和自我用药行为的心理结构。使用 SPSS 软件版本 20 进行数据分析，显著水平为 0.05。采用描述性统计检验、卡方检验、配对 t 检验、独立 t 检验和单变量建模分析数据。
两组在自我用药方面无显著差异。对药物作用的认识不足是自我用药的最重要原因（p=0.50）。两组在知识、HBM 结构和自我用药行为方面无显著差异（p＞0.05）。然而，在实施干预后，两组在上述变量上存在显著差异（p＜0.05）。当调整混杂变量的影响时，两组在 HBM 的几乎所有结构及其行为上均存在显著差异（p＜0.05）。然而，HBM 的感知障碍模式在两组之间没有达到显著差异水平。
基于 Freire 的 AEM 的教育干预对 HBM 的结构及其自我用药行为产生了积极影响。HBM 的心理结构在倾听问题阶段受到影响。自我用药在行动反思阶段得到了调整，共同制定和评估行动计划，以实现行为目标。结果可能对参与老年患者护理的医疗保健专业人员具有重要意义。
当前对照试验 IRCT2013091814512N2. 于 2023 年 1 月 2 日注册-前瞻性注册，试验在伊朗临床试验注册中心注册 http://www.irct.ir 。
