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孤独感、感知到的社会支持及其变化可预测冠心病患者在 12 个月内的医疗依从性。

Loneliness, perceived social support, and their changes predict medical adherence over 12 months among patients with coronary heart disease.

机构信息

School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.

The Wright Institute, Berkeley, California, USA.

出版信息

Br J Health Psychol. 2024 Sep;29(3):814-832. doi: 10.1111/bjhp.12732. Epub 2024 May 23.

Abstract

OBJECTIVES

This study investigated whether changes in loneliness and perceived social support predicted medical adherence in patients with coronary heart disease (CHD) over 12 months. Moreover, short-term and long-term buffering effects of social support on the association between loneliness and medical adherence were systematically examined.

DESIGN

A three-wave longitudinal study.

METHODS

Participants were 255 CHD patients with a mean age of 63 years. Medical adherence, loneliness, and perceived social support were assessed at baseline, 3 months, and 12 months. Hierarchical regression analyses were conducted to examine the influences of loneliness and social support as well as their changes on medical adherence over 12 months. Moderation analyses were performed to test buffering effects of baseline social support and its changes against loneliness and its changes, respectively.

RESULTS

Changes in loneliness significantly predicted medical adherence at 12 months (β = -.23, p = .001) but not at 3 months (β = -.10, p = .142). Changes in social support predicted medical adherence at both 3 (β = .23, p = .002) and 12 months (β = .26, p = .001). Social support concurrently buffered the adverse impact of loneliness on medical adherence (B = .29, SE = .12, p = .020) at baseline but did not at 3 or 12 months (Bs = -.21 to .40, SEs = .12 to .30, ps = .177 to .847).

CONCLUSIONS

Findings highlight the importance of monitoring loneliness and perceived social support continuously over time for CHD patients to promote medical adherence.

摘要

目的

本研究旨在探讨孤独感和感知到的社会支持的变化是否能预测冠心病(CHD)患者在 12 个月内的医疗依从性。此外,系统地检验了社会支持对孤独感与医疗依从性之间关系的短期和长期缓冲效应。

设计

一项三波纵向研究。

方法

参与者为 255 名平均年龄为 63 岁的 CHD 患者。在基线、3 个月和 12 个月时评估了医疗依从性、孤独感和感知到的社会支持。采用分层回归分析来检验孤独感和社会支持的变化及其对 12 个月内医疗依从性的影响。进行调节分析以检验基线社会支持及其变化对孤独感及其变化的缓冲效应。

结果

孤独感的变化在 12 个月时显著预测了医疗依从性(β=-.23,p=.001),但在 3 个月时无显著预测作用(β=-.10,p=.142)。社会支持的变化在 3 个月(β=.23,p=.002)和 12 个月(β=.26,p=.001)时均预测了医疗依从性。社会支持在基线时缓冲了孤独感对医疗依从性的不利影响(B=.29,SE=.12,p=.020),但在 3 个月或 12 个月时无缓冲作用(B 值为 -.21 至.40,SE 值为.12 至.30,p 值为.177 至.847)。

结论

研究结果强调了冠心病患者需要持续监测孤独感和感知到的社会支持,以促进医疗依从性。

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