Adherence to Asthma Medication Regimens in Urban African American Adolescents: Application of Self-Determination Theory
Adherence to Asthma Medication Regimens in Urban African American Adolescents: Application of Self-Determination Theory
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DOI：
10.1037/a0033510
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发表时间：
2014-05-01
影响因子：
4.2
通讯作者：
Naar-King, Sylvie
中科院分区：
文献类型：
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作者：
Bruzzese, Jean-Marie;Carcone, April Idalski;Naar-King, Sylvie
目的：哮喘药物依从性较低，尤其是非裔美国青少年，他们是哮喘患病率、发病率和死亡率的高危群体。这项研究测试了自我决定理论（SDT）（一种动机理论）的效用，以解释非裔美国青少年对哮喘药物治疗方案的依从性。方法：我们使用了 168 名哮喘控制不佳的城市非裔美国青少年（中号年龄 = 13.94 岁；61% 男性）的基线数据，这些青少年是测试干预措施提高依从性的有效性试验的一部分。使用家庭哮喘管理系统量表对参与者及其护理人员进行访谈；本研究使用哮喘药物依从性分量表。青少年完成了四个哮喘特定量表，代表自主动机（一个重要性量表）、能力（一个置信度量表）和相关性（两个量表——家庭常规和父母支持）的 SDT 结构。使用多元线性回归，我们测试了 SDT 变量可以预测依从性的假设。结果：依从性与三个 SDT 变量显着相关：重要性、信心和家庭常规。在多变量分析中，家庭常规是哮喘依从性的唯一显着预测因素 (p < .001)。哮喘管理行为融入家庭成员并在家庭成员之间共享与更好的依从性相关。更大的信心与增加的依从性略有相关 (p > .07)。结论：虽然代表 SDT 结构的几个变量与依从性相关，但结果表明，与其他 SDT 结构相比，家庭惯例可能与非裔美国青少年的依从性更相关。因此，帮助家庭分享哮喘护理并更好地将其纳入日常安排可能是提高高危非裔美国青少年药物依从性的重要干预策略。
Objective: Asthma medication adherence is low, particularly among African American adolescents, a high-risk group with respect to asthma prevalence, morbidity, and mortality. This study tested the utility of self-determination theory (SDT), a theory of motivation, to explain adherence to asthma medication regimens in African American adolescents. Method: We used baseline data from 168 urban African American adolescents (M-age = 13.94 years; 61% male) with poorly controlled asthma who were part of a trial testing the efficacy of interventions to improve adherence. Participants and their caregivers were interviewed using the Family Asthma Management System Scale; this study used the Asthma Medication Adherence subscale. Adolescents completed four asthma-specific scales representing the SDT constructs of autonomous motivation (one importance scale), competence (one confidence scale), and relatedness (two scales-family routines and parental support). Using multiple linear regression, we tested the hypothesis that SDT variables would predict adherence. Results: Adherence was significantly correlated with three SDT variables-importance, confidence, and family routines. In multivariate analysis, family routines was the only significant predictor of asthma adherence (p < .001). Asthma management behaviors integrated into and shared among family members was associated with better adherence. Greater confidence was marginally associated with increased adherence (p > .07). Conclusion: Though several variables representing SDT constructs were correlated with adherence, results demonstrate that family routines may be more relevant for African American adolescents' adherence than other SDT constructs. Thus, helping families to share and better integrate asthma care into daily schedules may be an important intervention strategy to improve medication adherence among high-risk African American adolescents.