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类风湿关节炎患者的特定心理因素与药物依从性

Selected psychological factors and medication adherence in patients with rheumatoid arthritis.

作者信息

Bąk-Sosnowska Monika, Wyszomirska Julia, Daniel-Sielańczyk Anna

机构信息

Department of Psychology, Medical University of Silesia, Katowice, Poland.

出版信息

Reumatologia. 2021;59(2):90-97. doi: 10.5114/reum.2021.105433. Epub 2021 Apr 27.

Abstract

OBJECTIVES

The aim of the study was to determine the relationship between medication adherence (MA) and selected psychological factors in a group of patients with rheumatoid arthritis (RA).

MATERIAL AND METHODS

The cross-sectional study was conducted in four rheumatology outpatient clinics in Silesia, Poland. The tests used were the Medication Adherence Questionnaire (MAQ), the Multidimensional Health Locus of Control Scale (MHLC), the Coping Inventory for Stressful Situations (CISS), and the Mindful Attention Awareness Scale (MAAS). The analysis involved 106 adult patients diagnosed with RA at least 6 months before, who were prescribed medication, with disease at any stage and with stable comorbidities. Software was used to perform analyses of frequency, basic descriptive statistics, including the Kolmogorov-Smirnov test, Student's -test for independent samples, intergroup univariate variance, Pearson's correlation coefficient, Spearman's rank correlation ρ coefficient, Fisher's exact test and stepwise linear regression.

RESULTS

Powerful Others Health Locus of Control (PHLC), Internal Health Locus of Control (IHLC) and age of the subjects, (3, 102) = 8.05; < 0.001 explained 16.8% of the variation in the adherence level for the entire group. In the group of women PHLC and IHLC, (2, 80) = 10.04; < 0.001 were included in the model, which explained 18.1% of variation in MA. PHLC was the most significant factor in the group of women (β = 0.55; < 0.001) and in the entire group (β = 0.48; < 0.001). In the group of men, Social Diversion Style (SDS), (1, 21) = 5.81; = 0.02 was included in the model, which explained 17.9% of the variation in the MA level.

CONCLUSIONS

The study identified some psychological predictors of adherence, which explained 16.8% of the variability. Factors increasing the likelihood of medication adherence in patients with rheumatoid arthritis include a strong belief in the power of others, low level of internal health locus of control, and advanced age.

摘要

目的

本研究旨在确定一组类风湿性关节炎(RA)患者的用药依从性(MA)与所选心理因素之间的关系。

材料与方法

在波兰西里西亚的四家风湿病门诊进行了横断面研究。所使用的测试包括用药依从性问卷(MAQ)、多维健康控制点量表(MHLC)、应激情境应对量表(CISS)和正念注意觉知量表(MAAS)。分析涉及106名至少在6个月前被诊断为RA的成年患者,这些患者正在接受药物治疗,处于疾病的任何阶段且合并症稳定。使用软件进行频率分析、基本描述性统计,包括柯尔莫哥洛夫-斯米尔诺夫检验、独立样本t检验、组间单变量方差分析、皮尔逊相关系数、斯皮尔曼等级相关ρ系数、费舍尔精确检验和逐步线性回归。

结果

强大他人健康控制点(PHLC)、内在健康控制点(IHLC)和受试者年龄,(3, 102) = 8.05;P < 0.001解释了整个组依从性水平变异的16.8%。在女性组中,PHLC和IHLC,(2, 80) = 10.04;P < 0.001被纳入模型,该模型解释了MA变异的18.1%。PHLC是女性组(β = 0.55;P < 0.001)和整个组(β = 0.48;P < 0.001)中最显著的因素。在男性组中,社交转移风格(SDS),(1, 21) = 5.81;P = 0.02被纳入模型,该模型解释了MA水平变异的17.9%。

结论

该研究确定了一些依从性的心理预测因素,这些因素解释了16.8%的变异性。增加类风湿性关节炎患者用药依从性可能性的因素包括对他人力量的强烈信念、较低的内在健康控制点水平和高龄。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/17ca/8103406/f6bb6c6c047a/RU-59-43875-g001.jpg

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