School of Education, Zhengzhou University, Zhengzhou, China; Department of Psychology, Singapore General Hospital, Singapore.
Duke-NUS Medical School, Singapore.
Respir Med. 2021 Dec;190:106673. doi: 10.1016/j.rmed.2021.106673. Epub 2021 Nov 2.
To investigate the relationships between beliefs about medication, trust in physician, self-efficacy, and medication adherence in severe asthma patients.
A sample of 117 patients with a diagnosis of Severe Asthma on Step 4 or 5 of GINA assessment of control treatment ladder completed a one-time survey, including the shortened Medication Adherence Report Scale (MARS-5), Beliefs about Medicines Questionnaire (BMQ), Trust in Physician Scale (TIPS), and Self-Efficacy in Taking Medication (SEAMS).
Our study found that medication adherence was associated with trust in physician (p = 0.033); factor one of beliefs about medication - Necessity of taking medication (BMQ1-Necessity: p = 0.025); and two factors of self-efficacy in taking medication (SEAMS1-Difficulty: p = 0.001; SEAMS2-Uncertain: p = 0.005). Furthermore, two factors of self-efficacy and trust in physician together significantly mediated the relationship between beliefs about medication and medication adherence in a serial multiple mediator model.
Beliefs about medication are fundamental in affecting asthma patients' trust in physician and self-efficacy, which in turn impact medication adherence.
Interventions being developed to improve medication adherence may benefit from emphasizing on asthma patients' concerns about overuse and harm of medication. In addition, education program targeting to improve provider-patient relationship could help with patients' confidence in taking medication.
探讨严重哮喘患者的药物信念、对医生的信任、自我效能感与药物依从性之间的关系。
对处于 GINA 控制治疗阶梯第 4 或 5 步的 117 例重度哮喘患者进行了一次横断面调查，调查内容包括缩短版用药依从性报告量表（MARS-5）、药物信念问卷（BMQ）、医生信任量表（TIPS）和用药自我效能感量表（SEAMS）。
我们的研究发现，药物依从性与对医生的信任相关（p=0.033）；药物信念的一个因素 - 服药的必要性（BMQ1-必要性：p=0.025）；以及用药自我效能的两个因素（SEAMS1-困难：p=0.001；SEAMS2-不确定：p=0.005）。此外，在串联多重中介模型中，自我效能的两个因素和对医生的信任共同显著中介了药物信念和药物依从性之间的关系。
药物信念是影响哮喘患者对医生的信任和自我效能感的基础，进而影响药物依从性。
为提高药物依从性而开发的干预措施可能受益于强调哮喘患者对药物过度使用和危害的担忧。此外，针对改善医患关系的教育计划可能有助于提高患者对用药的信心。
