Using the theory of planned behavior to improve treatment adherence in Mexican Americans with schizophrenia.
Using the theory of planned behavior to improve treatment adherence in Mexican Americans with schizophrenia.
复制标题
利用计划行为理论提高患有精神分裂症的墨西哥裔美国人的治疗依从性。
DOI：
10.1037/a0039346
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发表时间：
2015
影响因子：
5.9
通讯作者：
Mintz,Jim
中科院分区：
文献类型：
--
作者：
Kopelowicz,Alex;Zarate,Roberto;Wallace,CharlesJ;Liberman,RobertPaul;Lopez,StevenR;Mintz,Jim
目的：未能坚持抗精神病药物治疗是精神分裂症患者复发的最常见原因。根据计划行为理论（TPB），一种新的多家庭群体（MFG）干预在增加精神分裂症患者的药物依从性和减少再住院方面表现出疗效。本报告探讨了通过MFG方法获得的改善结果是由患者对药物态度的改变、主观规范-社会影响和感知的资源行为控制所介导的。方法采用最近完成的一项MFG随机对照试验的数据来验证依从性改善是由3个TPB因素介导的假设。研究对象是174名患有精神分裂症谱系障碍的墨西哥裔美国成年人，他们参加了一项以改善药物依从性为重点的MFG研究。在基线和4、8、12、18和24个月时进行评估。结果路径分析显示，与MFG相关的依从性增加是由主观规范的改善介导的，而不是对药物的态度或感知行为控制的改善。结论一项专门针对墨西哥裔美国人精神分裂症患者的MFG治疗通过教育家庭成员如何支持其患病亲属的药物依从性来发挥社会影响，从而获得了效果。
ObjectiveFailure to adhere to treatment with antipsychotic medication is the most common cause of relapse among patients with schizophrenia. A novel multifamily group (MFG) intervention, informed by the Theory of Planned Behavior (TPB), demonstrated efficacy in increasing medication adherence and decreasing rehospitalizations in schizophrenia patients. This report explores the hypothesis that the improved outcomes obtained through the MFG approach were mediated by changes in the patients’ attitudes toward medications, subjective norms-social influences, and perceived behavioral control of resources.MethodData from a recently completed, randomized controlled trial of MFG was used to test the hypothesis that the improvement in adherence was mediated by the 3 TPB factors. Subjects were 174 Mexican American adults with schizophrenia-spectrum disorder who had participated in a study of MFG focused on improving medication adherence. Assessments occurred at baseline and at 4, 8, 12, 18, and 24 months.ResultsPath analysis revealed that the increased adherence associated with MFG was mediated by improvements in subjective norms but not attitudes toward medications nor perceived behavioral control.ConclusionAn MFG treatment specifically tailored to increase medication adherence among Mexican Americans with schizophrenia achieved its benefits by leveraging social influences through teaching family members how to support medication adherence in their ill relatives.