The impact of parents' medication beliefs on asthma management
The impact of parents' medication beliefs on asthma management
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DOI：
10.1542/peds.2006-3023
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发表时间：
2007-09-01
期刊：
影响因子：
8
通讯作者：
Cabana, Michael D.
中科院分区：
文献类型：
--
作者：
Conn, Kelly M.;Halterman, Jill S.;Cabana, Michael D.
背景先前的研究表明，父母对哮喘药物的信念与药物依从性之间存在关系。目前尚不清楚父母对药物的积极和消极情绪如何相互作用，以影响药物依从性。本研究的目的是描述父母对孩子哮喘药物治疗的需求和关注，并评估这些积极和消极信念对父母报告的依从性的加权影响。我们对密歇根州东南部哮喘儿童的父母进行了一项横断面调查，应答率为71%。纳入了报告使用预防性哮喘药物的儿童（n = 622）。我们使用了一个有效的信念关于药物问卷（2个分量表：必要性和关注），以评估父母的积极和消极的态度，他们的孩子的药物。为了衡量父母如何权衡这些信念，我们还计算了必要性-关注差异得分（必要性和关注分量表之间的差异）。我们使用了4项家长报告量表来衡量药物依从性。大多数孩子都不是少数民族。总体而言，72%的父母认为他们的孩子的哮喘药物是必要的，30%的人对药物有强烈的担忧。对于77%的父母，必要性得分高于关注得分，17%的父母，关注超过必要性。与少数民族父母相比，非少数民族父母的必要性分数更有可能超过关注分数（79%对68%）。平均依从性得分随着必要性-关注差异的增加而增加。在多变量混合模型回归中，更大的必要性关注差异评分和非少数群体预测更好的依从性。这些发现证实了哮喘儿童父母的用药信念和依从性之间的关系。更好地了解父母的用药信念及其对依从性的影响可能有助于临床医生有效地促进依从性。
BACKGROUND. Previous studies suggest a relationship between parental beliefs about asthma medications and medication adherence. It is not clear how parents' positive and negative feelings about medications interact to influence medication adherence.OBJECTIVES. The objectives of this study were to describe parents' perceived need for and concerns about their child's asthma medications and to assess the weighted impact of these positive and negative beliefs on parent-reported adherence.METHODS. We conducted a cross-sectional survey of parents of children with asthma in southeast Michigan; response rate was 71%. Children with reported use of a preventive asthma medication were included ( n = 622). We used a validated Beliefs About Medications Questionnaire ( 2 subscales: necessity and concern) to assess parents' positive and negative attitudes about their child's medications. To measure how parents weigh these beliefs, we also calculated a necessity-concern differential score ( difference between necessity and concern subscales). We used a 4-item parent-report scale to measure medication adherence.RESULTS. The majority of children were nonminority. Overall, 72% of parents felt that their child's asthma medications were necessary, and 30% had strong concerns about the medications. For 77% of parents, necessity scores were higher than concern scores, and for 17%, concern exceeded necessity. Nonminority parents were more likely to have necessity scores exceed concern scores compared with minority parents ( 79% vs 68%). Mean adherence scores increased as the necessity-concern differential increased. In a multivariate mixed-model regression, a greater necessity-concern differential score and being nonminority predicted better adherence.CONCLUSIONS. These findings confirm a relationship between medication beliefs and adherence among parents of children with asthma. A better understanding of parents' medication beliefs and their impact on adherence may help clinicians counsel effectively to promote adherence.