Perceived adherence to prescribed treatment in juvenile idiopathic arthritis over a one-year period
Perceived adherence to prescribed treatment in juvenile idiopathic arthritis over a one-year period
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DOI：
10.1002/art.22534
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发表时间：
2007-03-15
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影响因子：
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通讯作者：
Duffy, Ciaran M.
中科院分区：
文献类型：
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作者：
Feldman, Debbie Ehrmann;De Civita, Mirella;Duffy, Ciaran M.
Objective.记录幼年特发性关节炎（JIA）患者1年内对治疗（服药和运动）的依从性，并确定相关因素。我们调查了蒙特利尔儿童医院和温哥华的不列颠哥伦比亚省儿童医院的JIA患者的父母。父母被要求在12个月内每3个月回答一系列问卷。在父母依从性报告问卷（PARQ）中，采用100 mm视觉模拟量表（VAS）评价感知依从性。父母的应对方式，痛苦，儿童功能，疾病的严重程度和持续时间，治疗的帮助，遇到的问题，社会人口学数据也进行了评估。175例患儿的平均年龄为10.2岁，诊断时的平均年龄为6.1岁，平均病程为4.1年。对药物的依从性持续较高，基线、3、6、9和12个月时PARQ VAS的平均依从性分别为86.1、91.7、90.4、92.0和88.8。对运动的坚持性较低，但保持稳定，相应的平均值分别为54.5，64.1，61.2，63.0和54.3。采用广义估计方程分析，与儿童自觉服药依从性较高相关的因素包括自觉服药有益性和较低的疾病严重程度;与儿童自觉锻炼依从性较高相关的因素包括儿童年龄较小、儿童参与治疗责任和自觉服药有益性较高。治疗有益的信念与较高的父母认为坚持治疗。
Objective. To document perceived adherence to treatment (taking medications and performing exercises) in patients with juvenile idiopathic arthritis (JIA) over a 1-year period and to identify related factors.Methods. We surveyed parents of patients with JIA at the Montreal Children's Hospital and British Columbia's Children's Hospital in Vancouver. Parents were asked to respond to a series of questionnaires every 3 months over a 12-month period. Perceived adherence was evaluated on a 100-mm visual analog scale (VAS) in the Parent Adherence Report Questionnaire (PARQ). Parental coping, distress, child function, disease severity and duration, perceived helpfulness of treatment, problems encountered, and sociodemographic data were also assessed.Results. The mean age of our sample of 175 children was 10.2 years; mean age at diagnosis was 6.1 years and mean disease duration was 4.1 years. Perceived adherence to medications was consistently high, with average adherence at baseline, 3, 6, 9, and 12 months being 86.1, 91.7, 90.4; 92.0, and 88.8, respectively, on the PARQ VAS. Perceived adherence to exercise was lower but remained steady, with corresponding means of 54.5, 64.1, 61.2, 63.0, and 54.3, respectively. Using generalized estimating equation analysis, factors associated with higher perceived adherence to medications included perceived helpfulness of medications and lower disease severity; those associated with higher perceived adherence to exercise were younger age of the child, child involvement in responsibility for treatment, and higher perceived helpfulness of the treatment.Conclusion. Belief in helpfulness of treatment is associated with higher parental perceived adherence to treatment.