Effects of Physician Communication and Family Hardiness on Patient Medication Regimen Beliefs and Adherence.
Effects of Physician Communication and Family Hardiness on Patient Medication Regimen Beliefs and Adherence.
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DOI：
10.4172/2327-5146.1000136
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发表时间：
2014-04
期刊：
影响因子：
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通讯作者：
Todd Molfenter;Roger L. Brown
中科院分区：
文献类型：
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作者：
Todd Molfenter;Roger L. Brown
本研究旨在建立一个模型，描述医生沟通和家庭的抵抗力如何影响患者对药物治疗方案的信念和依从性，以控制糖尿病和高脂血症（高胆固醇）。研究参与者（n=1356）完成了关于健康信念的自我报告问卷。美国一项健康计划的药房补充记录提供了他们服药依从性的数据。采用结构方程模型对变量关系进行建模。一项中介分析表明，当患者的服药健康信念与方案的感知益处、副作用影响和方案成本相关时，医生沟通行为对患者坚持方案的行为意愿和药物依从性有显著影响。相反，家庭适应力对服药行为没有影响。为了改善患者服药行为，医生沟通行为应该有针对性。研究表明，医生最初的方案讨论对于方案的开始和长期坚持都很重要，并且应该强调方案的好处和如何避免常见的副作用。此外，建立随访医患关系可以提高治疗方案的依从性，并减少患者因费用问题而停止服药的可能性。该研究支持了医生在健康行为维持中发挥的重要作用。未来的研究应该研究医生对其他反复出现的健康行为的影响。
This study aims to develop a model that describes how physician communication and family hardiness affect medication regimen beliefs and adherence for patients on regimens to control diabetes and hyperlipidemia (high cholesterol). Study participants (n=1356) completed self-report questionnaires on health beliefs. Pharmacy refill records from a health plan in the United States provided data on their medication adherence. Structural equation modeling was used to model variable relationships. A mediation analysis demonstrated that physician communication behaviors had a significant impact on the patients' behavioral intention to adhere to their regimen and medication adherence when they were mediated by the patient's medication taking health beliefs related to perceived benefit of the regimen, impact of side effects, and cost of regimen. Conversely, family hardiness had no effect on medication-taking behaviors. To improve patient medication-taking behaviors, physician communication behaviors should be targeted. The study suggests the physician's initial regimen discussion is important to both regimen initiation and long-term adherence, and should emphasize the regimen's benefits and how to avoid common side effects. Also, establishing a follow-up physician-patient relationship can enhance regimen adherence and reduce the likelihood that a patient will stop taking the medication due to cost concerns. The research supports the important role the physician plays in health behavior maintenance. Future research should study the effect physicians have on other recurring health behaviors.