Institute of Chinese Medical Sciences, University of Macau, Macau, China.
State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Macau, China.
Front Public Health. 2022 Apr 14;10:845032. doi: 10.3389/fpubh.2022.845032. eCollection 2022.
To explore the influence of parents on the medication adherence of their children.
A cross-sectional online investigation.
A questionnaire with 41 questions was designed based on the health belief model (HBM) distributed and collected online in 28 cities around China through multi-stage stratified sampling. The reliability of the questionnaire was assessed with Cronbach's α coefficient and split-half reliability, and its validity was evaluated with exploratory factor analysis and content validity index. The structural equation model (SEM) was constructed to explore the relationship between the parents' health beliefs and their children's medication adherence. Subgroup analysis was conducted to study the differences between parents with different demographic characteristics (male and female, rural and urban).
573 questionnaires were included for analysis, with an effective rate of 62.97%. The Cronbach'α coefficient of the questionnaire was 0.821 > 0.6, the split-half reliability was 0.651 > 0.6, the I-CVI of each dimension were >0.78, and the S-CVI/AVE (I-CVI average) was 0.95 > 0.9. The result of the questionnaire exploratory factor analysis met the standard. According to the SEM, self-efficacy (λ = 0.177), perceived susceptibility (λ = -0.244), and perceived severity (λ = 0.243) were direct influencing factors of children's medication adherence. In the subgroup analysis, the model established by each subgroup was consistent with the model established by the overall sample. The absolute values of females' perceived susceptibility, severity, and self-efficacy for their children's medication adherence path coefficients were higher than males'.
Parents' perceived severity and self-efficacy may positively impact on their children's medication adherence, while parents' susceptibility to children's medication non-adherence may negatively impact on children's medication adherence. Objective constraints, perceived barriers, and benefits may in directly impact on children's medication adherence. Women's health beliefs appear to have a more significant impact on their children's medication adherence than men's. It may be an effective strategy to increase their children's medication adherence by improving parents' health beliefs. Medical staff should explain medication adherence knowledge to the parents of children, and inform the children of the possible consequences of non-adherence with medication, to improve the subjective perception of parents on the severity of children's non-adherence with medication, and improve parents' self-efficacy in rational medication for children. In addition, attention should be paid to the mental health of the parents, and more social and psychological support.
探讨父母对子女用药依从性的影响。
横断面在线调查。
采用健康信念模式（HBM）设计问卷，通过多阶段分层抽样，在中国 28 个城市进行在线问卷调查。采用 Cronbach's α 系数和分半信度评估问卷的信度，采用探索性因子分析和内容效度指数评估问卷的效度。构建结构方程模型（SEM）探讨父母健康信念与子女用药依从性的关系。进行亚组分析，研究不同人口统计学特征（男性和女性、农村和城市）父母之间的差异。
共纳入 573 份问卷进行分析，有效率为 62.97%。问卷的 Cronbach'α 系数为 0.821＞0.6，分半信度为 0.651＞0.6，各维度的 I-CVI 均＞0.78，S-CVI/AVE（I-CVI 平均值）为 0.95＞0.9。问卷探索性因子分析结果符合标准。根据 SEM，自我效能（λ=0.177）、感知易感性（λ=-0.244）和感知严重性（λ=0.243）是儿童用药依从性的直接影响因素。在亚组分析中，每个亚组建立的模型与总体样本建立的模型一致。女性对子女用药非依从性的感知易感性、严重性和自我效能感的路径系数绝对值高于男性。
父母对子女用药的感知严重性和自我效能感可能对子女的用药依从性产生积极影响，而父母对子女用药不依从性的感知易感性可能对子女的用药依从性产生负面影响。客观约束、感知障碍和益处可能间接地影响儿童的用药依从性。女性的健康信念似乎对子女的用药依从性影响比男性更大。通过提高父母的健康信念，增加他们对子女用药依从性的了解，可能是提高子女用药依从性的有效策略。医务人员应向患儿家长讲解用药依从性知识，告知患儿不遵医嘱用药的可能后果，提高家长对患儿用药不依从严重性的主观认识，提高家长对患儿合理用药的自我效能感。此外，应关注家长的心理健康，给予更多的社会和心理支持。
