Choi Yoon-A, Kweon Young-Ran
Department of Nursing, Chonnam National University Hospital, Gwangju, South Korea.
Department of Nursing, Chonnam National University, Gwangju, South Korea.
Patient Prefer Adherence. 2023 May 12;17:1247-1255. doi: 10.2147/PPA.S408781. eCollection 2023.
This study examined the mediating effect of medication adherence self-efficacy (MASE) on the relationship between drug attitude (DA) and medication adherence (MA) in patients with early psychosis.
A total of 166 patients, aged 20 years or older, and who had received treatment within 5 years of their initial psychotic episode at a University Hospital outpatient center, participated in the study. Data were analyzed using descriptive statistics, -tests, one-way analysis of variance, Pearson's correlation coefficients, and multiple linear regression. Additionally, a bootstrapping test was conducted to determine the statistical significance of the mediating effect. All study procedures adhered to Strengthening the reporting of observational studies in epidemiology (STROBE) guidelines.
This study found a significant correlation between MA and DA (r=0.393, p<0.001), and between MA and MASE (r=0.697, p<0.001). MASE had a partial mediating effect on the association between DA and MA. The model that integrated both DA and MASE accounted for 53.4% of the variation in MA. Bootstrapping analysis indicated that MASE was a significant partial parameter (lower limit confidence interval [CI] 0.114; upper limit CI 0.356). Further, 64.5% of the study participants were either currently enrolled in college or had higher levels of education.
These findings could potentially lead to a more personalized approach to medication education and adherence, considering the unique DA and MASE of each patient. By identifying the mediating effect of MASE on the relationship between DA and MA, healthcare providers could tailor interventions to enhance the ability of patients with early psychosis to adhere to prescribed medication regimens.
本研究探讨了药物治疗依从性自我效能感（MASE）在早期精神病患者的药物态度（DA）与药物治疗依从性（MA）之间关系中的中介作用。
共有166名年龄在20岁及以上、在大学医院门诊中心首次精神病发作后5年内接受治疗的患者参与了本研究。数据采用描述性统计、t检验、单因素方差分析、Pearson相关系数和多元线性回归进行分析。此外，还进行了自抽样检验以确定中介效应的统计显著性。所有研究程序均遵循加强流行病学观察性研究报告（STROBE）指南。
本研究发现MA与DA之间存在显著相关性（r = 0.393，p < 0.001），MA与MASE之间也存在显著相关性（r = 0.697，p < 0.001）。MASE在DA与MA的关联中具有部分中介作用。整合了DA和MASE的模型解释了MA变异的53.4%。自抽样分析表明MASE是一个显著的部分参数（下限置信区间[CI] 0.114；上限CI 0.356）。此外，64.5%的研究参与者目前正在上大学或具有较高教育水平。
考虑到每位患者独特的DA和MASE，这些发现可能会导致更个性化的药物治疗教育和依从性方法。通过确定MASE在DA与MA关系中的中介作用，医疗保健提供者可以调整干预措施，以提高早期精神病患者坚持规定药物治疗方案的能力。
