Engagement and Affective Communication During Pediatric Nephrology Clinic Visits: Associations with Medication Adherence.
Engagement and Affective Communication During Pediatric Nephrology Clinic Visits: Associations with Medication Adherence.
复制标题
DOI：
10.1016/j.pec.2020.08.039
复制
发表时间：
2021-03
影响因子：
3.5
通讯作者：
Eaton CK
中科院分区：
文献类型：
--
作者：
Glenn TW;Riekert KA;Roter D;Eakin MN;Pruette CS;Brady TM;Mendley SR;Tuchman S;Fivush BA;Eaton CK
目的：评估慢性肾脏疾病(CKD)青少年和青壮年(AYA)患者、照顾者和儿科肾病提供者在门诊就诊期间的参与度和情感交流是否能预测抗高血压药物的依从性。Ayas(n=60，男性=15.4岁，SD=2.7，女性占40%，非裔美国人/黑人占43%)和照顾者(n=60，女性占73%)去看儿科肾病医生(n=12，女性占75%)。使用Roter互动分析系统的全球情感评级对录音进行分析。在就诊前和就诊后对抗高血压药物依从性进行电子监测。线性回归模型评估了情感评分和访问后依从性之间的关联。Ayas在访问前接受了84%的剂量(SD=20%)，在访问后接受了82%的剂量(SD=24%)。更高的AYA参与度(β=0.03，p=0.01)和没有提供者的负面影响(β=−=0.15，p=0.04)与更高的访问后依从性相关，控制了访问前的依从性、Aya的性别、年龄和种族，并按提供者分组。当AYA被评为参与度更高，提供者被评为不那么负面时，访问后的依从性更高。参与度较低的AYAS可能会从进一步的遵守评估中受益。旨在更积极地让AYA参与护理并减少提供者在门诊期间传递负面影响的沟通策略可能会对AYA对CKD的坚持产生积极影响。
To evaluate whether engagement and affective communication among adolescents and young adults (AYAs) with chronic kidney disease (CKD), caregivers, and pediatric nephrology providers during outpatient clinic visits predicts antihypertensive medication adherence. AYAs (n=60, M age=15.4 years, SD=2.7, 40% female, 43% African American/Black) and caregivers (n=60, 73% female) attended audio-recorded clinic visits with pediatric nephrologists (n=12, 75% female). Recordings were analyzed using global affect ratings of the Roter Interactional Analysis System. Antihypertensive medication adherence was monitored electronically before and after clinic visits. A linear regression model evaluated associations between affect ratings and post-visit adherence. AYAs took 84% of doses (SD=20%) pre-visit and 82% of doses (SD=24%) post-visit. Higher AYA engagement (β=0.03, p=.01) and the absence of provider negative affect (β=−0.15, p=.04) were associated with higher post-visit adherence, controlling for pre-visit adherence, AYA sex, age, and race, and clustered by provider. Post-visit adherence was higher when AYAs were rated as more engaged and providers as less negative. AYAs with lower engagement may benefit from further adherence assessment. Communication strategies designed to more actively engage AYAs in their care and diminish provider conveyance of negative affect during clinic visits may positively influence adherence among AYAs with CKD.
登录
查看更多内容
影响因子：
2.2
作者：
Miller, Victoria A.;Jawad, Abbas F.
通讯作者：
Jawad, Abbas F.
影响因子：
2.5
作者：
Castillo, Enrico G.;Pincus, Harold A.;Cruz, Mario
通讯作者：
Cruz, Mario
影响因子：
8
作者：
Sleath, Betsy;Carpenter, Delesha M.;Ayala, Guadalupe X.
通讯作者：
Ayala, Guadalupe X.
影响因子：
3.6
作者：
Eaton, Cyd K.;Eakin, Michelle N.;Riekert, Kristin A.
通讯作者：
Riekert, Kristin A.
影响因子：
3
作者：
Pruette, Cozumel S.;Coburn, Shayna S.;Riekert, Kristin A.
通讯作者：
Riekert, Kristin A.