接受血液透析的美国黑人的药物依从性、健康结局及感知社会表现
Medication adherence, health outcomes, and perceived social performance in Black Americans receiving hemodialysis.
作者信息
Wild Marcus G, Greevy Robert A, Cavanaugh Kerri L, Nair Devika, Fissell Rachel B, Bachorowski Jo-Anne, Umeukeje Ebele M
机构信息
Department of Psychological Sciences, Vanderbilt University.
Department of Biostatistics, Vanderbilt University Medical Center.
出版信息
Health Psychol. 2025 Jul 31. doi: 10.1037/hea0001543.
OBJECTIVE
Social performance-the ability to successfully engage in social interactions-impacts outcomes in end-stage kidney disease (ESKD), including depressive symptoms and low self-efficacy, that are disproportionately experienced by Black Americans. However, the associations between social performance and health behaviors in ESKD are unknown. Social-emotional expertise (SEE) is a construct of individual differences in social performance that may be relevant to ESKD outcomes. Study goals are to establish the relation between SEE and health behaviors in Black American patients with ESKD by (a) examining the association of SEE with depressive symptoms, self-efficacy, and trust-in-physician and (b) the prediction of medication nonadherence and serum phosphorus by SEE.
METHOD
Ninety-nine Black Americans receiving in-center hemodialysis completed surveys at baseline and two follow-up visits over 12 months. Bayesian regression captured relations among self-efficacy, depressive symptoms, medication nonadherence, serum phosphorus, and SEE scale scores.
RESULTS
SEE was positively associated with self-efficacy and negatively associated with depressive symptoms at baseline. Additionally, baseline SEE significantly predicted 12-month medication nonadherence (² = .16, 95% credible interval = [.06, .26]) when accounting for self-efficacy and depressive symptoms. SEE at baseline did not predict 12-month serum phosphorus; however, a model with baseline SEE in combination with baseline depressive symptoms did predict 12-month serum phosphorus (² = .10, 95% credible interval = [.02, .21]).
CONCLUSIONS
Higher perceived social performance-as measured by the SEE scale-predicted self-efficacy, depressive symptoms, and medication nonadherence, but not serum phosphorus control, in a cohort of Black Americans with ESKD. Socially focused interventions may have a positive impact on health behaviors among Black patients with ESKD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
目的
社交能力——成功参与社交互动的能力——会影响终末期肾病（ESKD）的预后，包括抑郁症状和低自我效能感，而美国黑人在这些方面的经历尤为严重。然而，ESKD患者社交能力与健康行为之间的关联尚不清楚。社会情感专业知识（SEE）是社交能力方面个体差异的一个概念，可能与ESKD的预后相关。研究目标是通过以下方式确定美国黑人ESKD患者的SEE与健康行为之间的关系：（a）研究SEE与抑郁症状、自我效能感和对医生的信任之间的关联；（b）用SEE预测药物治疗不依从性和血清磷水平。
方法
99名接受中心血液透析的美国黑人在基线时以及在12个月内的两次随访中完成了调查。贝叶斯回归分析了自我效能感、抑郁症状、药物治疗不依从性、血清磷水平和SEE量表得分之间的关系。
结果
基线时，SEE与自我效能感呈正相关，与抑郁症状呈负相关。此外，在考虑自我效能感和抑郁症状的情况下，基线SEE能显著预测12个月后的药物治疗不依从性（β = 0.16，95%可信区间 = [0.06, 0.26]）。基线SEE不能预测12个月后的血清磷水平；然而，一个包含基线SEE和基线抑郁症状的模型确实能预测12个月后的血清磷水平（β = 0.10，95%可信区间 = [0.02, 0.21]）。
结论
在一组美国黑人ESKD患者中，用SEE量表衡量的较高的社交能力感知能预测自我效能感、抑郁症状和药物治疗不依从性，但不能预测血清磷水平的控制情况。以社交为重点的干预措施可能会对黑人ESKD患者的健康行为产生积极影响。（《心理学文摘数据库记录》（c）2025美国心理学会，保留所有权利）
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