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辅助内分泌治疗的乳腺癌患者药物依从性与疾病认知的关系:将药物信念作为中介。

The relationship between medication adherence and illness perception in breast cancer patients with adjuvant endocrine therapy: beliefs about medicines as mediators.

机构信息

School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong Province, China.

Tian Shui Health Commission, Tianshui, Gansu Province, China.

出版信息

Support Care Cancer. 2022 Dec;30(12):10009-10017. doi: 10.1007/s00520-022-07411-w. Epub 2022 Oct 20.

Abstract

PURPOSE

To describe medication adherence, to analyze the relationships among medication adherence, illness perception, and beliefs about medicines, and to determine the mediating effects of beliefs about medicines on the relationship in breast cancer patients with adjuvant endocrine therapy (AET) in China.

METHODS

A cross-sectional study was conducted on 202 breast cancer patients with AET from September 2017 to February 2019 in China. The Medication Adherence Report Scale (MARS-5), the Chinese version of the revised illness perception questionnaire for Breast Cancer (CIPQ-R-BC) and the Beliefs about Medicines Questionnaire (BMQ) were used.

RESULTS

The mean MARS-5 score of our participants was 23.72 (SD = 1.62), and 175 (86.6%) patients were adherent to medications. Moreover, medication adherence was negatively correlated with identity, environmental or immune factors, emotional representations, BMQ-specific concerns, BMQ-general overuse, and BMQ-general harm, as well as being positively correlated with coherence and the total BMQ scores. Furthermore, beliefs in the overuse about medicines functioned as mediators for the influencing effects of coherence and emotional representations on medication adherence.

CONCLUSION

Illness perception not only directly affected medication adherence, but also indirectly affected medication adherence through the beliefs about medicines. Necessary interventions that target beliefs in the overuse about medicines in breast cancer patients with AET with low levels of coherence or high levels of emotional representations could be provided to improve the level of their medication adherence.

摘要

目的

描述药物依从性,分析药物依从性、疾病感知、对药物的信念之间的关系,并确定在中国接受辅助内分泌治疗(AET)的乳腺癌患者中对药物的信念对这种关系的中介作用。

方法

本研究采用横断面研究,于 2017 年 9 月至 2019 年 2 月在中国招募了 202 名接受 AET 的乳腺癌患者。采用药物依从性报告量表(MARS-5)、修订后的乳腺癌疾病感知问卷中文版(CIPQ-R-BC)和对药物的信念问卷(BMQ)对患者进行评估。

结果

参与者的 MARS-5 平均得分为 23.72(SD=1.62),175 名(86.6%)患者服药依从性良好。此外,药物依从性与身份、环境或免疫因素、情绪表达、BMQ 特异性顾虑、BMQ 一般性过度使用和 BMQ 一般性危害呈负相关,与一致性和 BMQ 总分呈正相关。此外,对药物过度使用的信念是一致性和情绪表达对药物依从性的影响的中介变量。

结论

疾病感知不仅直接影响药物依从性,还通过对药物的信念间接影响药物依从性。对于一致性水平较低或情绪表达水平较高的接受 AET 的乳腺癌患者,可以提供针对过度使用药物的信念的必要干预措施,以提高他们的药物依从性。

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