Methodological issues in adherence to cancer control regimens.
Methodological issues in adherence to cancer control regimens.
复制标题
遵守癌症控制方案的方法学问题。
DOI：
10.1016/0091-7435(89)90042-x
复制
发表时间：
1989
影响因子：
5.1
通讯作者：
Hays,RD
中科院分区：
文献类型：
--
作者：
Gritz,ER;DiMatteo,MR;Hays,RD
六因素模型为理解遵医行为提供了启发式框架：(1)有效的提供者沟通；(2)与供应商的关系融洽;(3)客户的信念和态度；(4)客户的社会氛围和规范；(5)行为意向；(6)对依从性的支持和障碍。本文讨论了四类方法论问题。招募可能受到目标人群的社会人口统计学、生物医学变量、人口规模和位置以及所利用的患者来源的影响。干预措施可以结构化，以最大限度地提高入学率，参与和长期保留，并坚持与行为方法论促进的方案。最佳的依从性测量包括多个时间点的多个测量，明确定义的焦点和依从性单元，良好构建的响应选项和多个信息来源。临床试验结果的样本量计算和解释受到依从率的影响。多元分析技术，如结构方程建模，可以指定模型来描述不同理论结构之间的假设结构关系，并评估这些模型的合理性。
A six-factor model provides a heuristic framework for understanding adherence behavior: (1) effective provider communication; (2) rapport with provider; (3) client's beliefs and attitudes; (4) client's social climate and norms; (5) behavioral intentions; and (6) supports for and barriers to adherence. Four classes of methodological issues are discussed. Recruitment may be affected by the sociodemographics of the target population, biomedical variables, population size and location, and patient sources utilized. Interventions can be structured to maximize enrollment, participation and long-term retention, and adherence to the regimen promoted with behavioral methodology. Measurement of adherence optimally includes multiple measures at multiple time points, a well-defined focus and unit of adherence, well-constructed response options, and multiple sources of information. Sample size calculations and interpretation of clinical trial results are affected by adherence rates. Multivariate analytic techniques, such as structural equation modeling, make it possible to specify models depicting hypothesized structural relationships between different theoretical constructs and to evaluate the plausibility of these models.