Wu Jyh-Jeng, Chen Yueh-Mei, Talley Paul C, Kuo Kuang-Ming
Department of Business Management, National United University, Miaoli 360001, Taiwan.
Miaoli General Hospital, Ministry of Health and Welfare, Miaoli 36054, Taiwan.
Int J Environ Res Public Health. 2021 May 12;18(10):5100. doi: 10.3390/ijerph18105100.
Effectively improving the medication adherence of patients is crucial. Past studies focused on treatment-related factors, but little attention has been paid to factors concerning human beliefs such as trust or self-efficacy. The purpose of this study is to explore the following aspects of patients with chronic diseases: (1) The relationship between emotional support, informational support, self-efficacy, and trust; (2) the relationship between self-efficacy, trust, and medication adherence; and, (3) whether chronic patients' participation in different types of online communities brings about significant statistical differences in the relationships between the abovementioned variables. A questionnaire survey was conducted in this study, with 452 valid questionnaires collected from chronic patients previously participating in online community activities. Partial Least Squares-Structural Equation Modeling analysis showed that emotional support and informational support positively predict self-efficacy and trust, respectively, and consequently, self-efficacy and trust positively predict medication adherence. In addition, three relationships including the influence of emotional support on trust, the influence of trust on medication adherence, and the influence of self-efficacy on medication adherence, the types of online communities result in significant statistical differences. Based on the findings, this research suggests healthcare professionals can enhance patients' self-efficacy in self-care by providing necessary health information via face-to-face or online communities, and assuring patients of demonstrable support. As such, patients' levels of trust in healthcare professionals can be established, which in turn improves their medication adherence.
有效提高患者的用药依从性至关重要。过去的研究主要关注与治疗相关的因素，但很少关注诸如信任或自我效能感等与人类信念相关的因素。本研究的目的是探讨慢性病患者的以下几个方面：（1）情感支持、信息支持、自我效能感和信任之间的关系；（2）自我效能感、信任和用药依从性之间的关系；以及（3）慢性病患者参与不同类型的在线社区是否会使上述变量之间的关系产生显著的统计学差异。本研究采用问卷调查法，从之前参与过在线社区活动的慢性病患者中收集了452份有效问卷。偏最小二乘结构方程模型分析表明，情感支持和信息支持分别正向预测自我效能感和信任，因此，自我效能感和信任正向预测用药依从性。此外，情感支持对信任的影响、信任对用药依从性的影响以及自我效能感对用药依从性的影响这三种关系，在线社区的类型会导致显著的统计学差异。基于这些发现，本研究建议医疗保健专业人员可以通过面对面或在线社区提供必要的健康信息，并向患者保证能得到切实的支持，从而提高患者自我护理的自我效能感。这样一来，就可以建立患者对医疗保健专业人员的信任水平，进而提高他们的用药依从性。
