Abbott J, Dodd M, Webb A K
Department of Psychology, University of Central Lancashire, Preston, UK.
Thorax. 1996 Dec;51(12):1233-8. doi: 10.1136/thx.51.12.1233.
Clinical and demographic variables are poor predictors of treatment adherence. This study therefore examined the relationships between the patients' perception of their cystic fibrosis and their reported adherence to physiotherapy, exercise, pancreatic enzyme and vitamin therapies.
Sixty adults with cystic fibrosis completed the Health Perception Scale, Health Locus of Control Scale, and the Manchester Adult Cystic Fibrosis Compliance Questionnaire.
Reported adherence to physiotherapy, exercise, pancreatic enzyme and vitamin therapies was not influenced by patients' perceptions of their past, current and future disease severity, or their perceived susceptibility to recurrent infections. The greater their level of worry regarding their disease, the more likely they were to adhere to their physiotherapy (p < 0.002), pancreatic enzyme (p < 0.001) and vitamin (p < 0.001) regimens. No difference between the exercise adherent and non-adherent groups emerged regarding their level of worry. Compared with patients who believed that they were in control of their health, those who believed that their cystic fibrosis was controlled by others (family and health professionals) reported greater levels of adherence to their physiotherapy (p < 0.001), pancreatic enzyme (p < 0.001) and vitamin (p < 0.001) therapies. In contrast, patients who adhered to their exercise regimen believed that they were in control of their disease to a greater extent than those who did not (p < 0.003).
Worrying about cystic fibrosis and the perception of having little personal control over the disease facilitated treatment adherence. It is clear that patients perceive exercise therapy differently from other forms of treatment.
临床和人口统计学变量对治疗依从性的预测效果不佳。因此，本研究探讨了患者对自身囊性纤维化的认知与他们报告的物理治疗、运动、胰酶和维生素治疗依从性之间的关系。
60名成年囊性纤维化患者完成了健康认知量表、健康控制点量表和曼彻斯特成人囊性纤维化依从性问卷。
报告的物理治疗、运动、胰酶和维生素治疗依从性不受患者对其过去、当前和未来疾病严重程度的认知，或他们对反复感染易感性的认知影响。他们对疾病的担忧程度越高，就越有可能坚持物理治疗（p < 0.002）、胰酶治疗（p < 0.001）和维生素治疗（p < 0.001）方案。运动依从组和非依从组在担忧程度上没有差异。与认为自己能掌控自身健康的患者相比，那些认为自己的囊性纤维化由他人（家人和医疗专业人员）掌控的患者报告在物理治疗（p < 0.001）、胰酶治疗（p < 0.001）和维生素治疗（p < 0.001）方面的依从性更高。相比之下，坚持运动方案的患者比不坚持的患者更认为自己能掌控疾病（p < 0.003）。
对囊性纤维化的担忧以及认为自己对疾病几乎没有个人掌控力有助于提高治疗依从性。显然，患者对运动疗法的认知与其他治疗形式不同。
