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冠心病患者的疾病认知、自我效能感与药物依从性:概念模型的路径分析

Illness Perception, Self-Efficacy, and Medication Adherence in Patients With Coronary Artery Disease: A Path Analysis of Conceptual Model.

作者信息

Mobini Soheil, Allahbakhshian Atefeh, Shabanloei Reza, Sarbakhsh Parvin

机构信息

Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran.

Faculty of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

SAGE Open Nurs. 2023 Jun 12;9:23779608231171772. doi: 10.1177/23779608231171772. eCollection 2023 Jan-Dec.

Abstract

INTRODUCTION

Illness perception and self-efficacy in patients with coronary artery disease (CAD) may affect medication adherence, which is one of the most important challenges in disease management in this group of patients.

OBJECTIVE

The present study aimed to investigate the factors influencing medication adherence in CAD patients, especially the effect of illness perception and self-efficacy.

METHODS

This study was cross-sectional and conducted from April to September 2021. A total of 259 patients with confirmed CAD were selected by convenience sampling method based on inclusion criteria. Illness perception, self-efficacy, and medication adherence were investigated using Brief IPQ, SCSES, and MARS_10 questionnaires, respectively. The data were analyzed using the STATA software (version 14) and the regression path analysis method.

RESULTS

Patients had moderate illness perception and high self-efficacy, and 61.8 of them adhered to their medication regimen. Greater illness perception, better self-efficacy, and higher education had a positive effect on medication adherence, and increasing age had a negative effect on it. The final path model shows a good fit of the data in the model (χ2: 0.37, df: 274, χ2/df: 0.36, CFI: 1, IFI: 0.95, TLI: 1.07, and RMSEA: 0.00).

CONCLUSION

The results of the present study suggest that patients' illness perception can play an important role in predicting self-efficacy in disease management and the level of medication adherence in patients with CAD. To improve self-efficacy and medication adherence, future intervention studies should focus on the patient's illness perceptions and their improvement.

摘要

引言

冠心病(CAD)患者的疾病认知和自我效能可能会影响药物治疗依从性,而这是该组患者疾病管理中最重要的挑战之一。

目的

本研究旨在调查影响CAD患者药物治疗依从性的因素,尤其是疾病认知和自我效能的影响。

方法

本研究为横断面研究,于2021年4月至9月进行。根据纳入标准,采用方便抽样法共选取了259例确诊为CAD的患者。分别使用简化疾病认知问卷(Brief IPQ)、慢性疾病自我效能量表(SCSES)和药物治疗依从性评定量表(MARS_10)对疾病认知、自我效能和药物治疗依从性进行调查。使用STATA软件(版本14)和回归路径分析方法对数据进行分析。

结果

患者的疾病认知中等,自我效能较高,其中61.8%的患者坚持药物治疗方案。更高的疾病认知、更好的自我效能和更高的教育程度对药物治疗依从性有积极影响,而年龄增长则有负面影响。最终的路径模型显示模型中的数据拟合良好(χ2:0.37,自由度:274,χ2/自由度:0.36,比较拟合指数:1,增值拟合指数:0.95,Tucker-Lewis指数:1.07,近似误差均方根:0.00)。

结论

本研究结果表明,患者的疾病认知在预测疾病管理中的自我效能和CAD患者的药物治疗依从性水平方面可以发挥重要作用。为了提高自我效能和药物治疗依从性,未来的干预研究应关注患者的疾病认知及其改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6b2/10272659/690388251462/10.1177_23779608231171772-fig1.jpg

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