慢性髓性白血病患者中不利于治疗依从性的人格特质：A型和D型人格的作用。
Personality traits favourable for non-adherence to treatment in patients with chronic myeloid leukaemia: role of type A and D personality.
作者信息
Rychter Anna, Miniszewska Joanna, Góra-Tybor Joanna
机构信息
Department of Haematology, Medical University of Lodz, Lodz, Poland.
Department of Health Psychology, Institute of Psychology, Lodz University, Lodz, Poland.
出版信息
Biopsychosoc Med. 2023 Jan 19;17(1):1. doi: 10.1186/s13030-023-00261-w.
BACKGROUND
The introduction of BCR-ABL tyrosine kinase inhibitors (TKIs) to chronic myeloid leukemia (CML) therapy has revolutionized the treatment of this disease. Although regular TKI intake is a prerequisite for successful therapy, it has been shown that a significant proportion of patients are non-compliant. Recently there is growing evidence that personality traits may influenced the tendency for non-adherence to treatment in patients with chronic diseases. As far as we know, such a relationship in patients with CML has not been examined, yet. The aim of our study was to determine if personality traits favor non-adherence to treatment recommendations. We investigated the relationship between five-factor model personality factors (conscientiousness, neuroticism, agreeableness, extraversion, and openness) and medication non-adherence. We also checked if the patients with type A and type D personality, were at higher risk of poor medication adherence.
METHODS
The following tools were used: self-constructed survey, the NEO-Five Factor Inventory, the Framingham Type A Scale, the D-Scale 14. The study included 140 CML patients treated with imatinib, dasatinib, or nilotinib.
RESULTS
39% of patients reported skipping at least one dose of medication in the month prior to follow-up visit. 51% admitted to skipping such doses from the start of their treatment to the time at which our assessment was performed. We did not find any relationship between the mean values of the analyzed factors of the Big Five (neuroticism, extraversion, openness, agreeableness, conscientiousness) and adherence. However, our analysis revealed that CML patients who admitted to missing doses of drugs during the entire course of treatment demonstrated greater intensity of type A personality traits (p = 0.020). Regarding both factors of type D personality, it was revealed that higher level of negative affectivity significantly decreased the adherence (p = 0.020).
CONCLUSION
The results of our study indicate that screening for type D and A personalities may help to identify patients who are at higher risk of poor medication adherence.
背景
将BCR-ABL酪氨酸激酶抑制剂（TKIs）引入慢性髓性白血病（CML）治疗彻底改变了这种疾病的治疗方式。尽管规律服用TKI是成功治疗的前提，但已有研究表明，相当一部分患者并不依从。最近，越来越多的证据表明人格特质可能会影响慢性病患者不坚持治疗的倾向。据我们所知，CML患者中这种关系尚未得到研究。我们研究的目的是确定人格特质是否有利于不遵守治疗建议。我们调查了五因素模型人格因素（尽责性、神经质、宜人性、外向性和开放性）与药物不依从之间的关系。我们还检查了A型和D型人格的患者药物依从性差的风险是否更高。
方法
使用了以下工具：自行构建的调查问卷、NEO五因素问卷、弗雷明汉A型量表、D量表14。该研究纳入了140例接受伊马替尼、达沙替尼或尼洛替尼治疗的CML患者。
结果
39%的患者报告在随访前一个月至少漏服一剂药物。51%的患者承认从治疗开始到我们进行评估时漏服过此类药物。我们没有发现大五人格分析因素（神经质、外向性、开放性、宜人性、尽责性）的平均值与依从性之间存在任何关系。然而，我们的分析表明，在整个治疗过程中承认漏服药物的CML患者表现出更强的A型人格特质（p = 0.020）。关于D型人格的两个因素，结果显示较高水平的消极情感显著降低了依从性（p = 0.020）。
结论
我们的研究结果表明，筛查D型和A型人格可能有助于识别药物依从性差风险较高的患者。
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