Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지

Modeling Adherence to Therapeutic Regimens in Patients with Hypertension

  • Published : 2005.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose. This study was done to identify and test a model of the psychosocial variables that influence adherence to therapeutic regimens in patients with hypertension. Method. A convenience sample of 219 patients with hypertension who were enrolled in an outpatient clinic of a cardiovascular center in Korea participated in the study. They completed self-administered questionnaires anonymously. The questionnaire was based on the Social Action Theory model and a literature review. The explanatory model was constructed and tested using structural equation modeling in order to examine the effects within the model. Results. The results of this study showed that perceived self-efficacy was the strongest factor influencing patient adherence in this sample. Adherence to therapeutic regimens in patients with hypertension was influenced by self-efficacy, patient-provider relationship, social support, and depression. Conclusions. Adherence to therapeutic regimens in patients with hypertension was most strongly influenced by self-efficacy. These findings suggest that nursing interventions to promote patient adherence should focus on the promotion of self-efficacy including improvement in patient-provider relationship and social support, and reduction in depression.

Keywords

References

  1. Arnstein, P., Caudill, M., MandIe, C.L., Norris, A., & Beasley, R. (1999). Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80(3), 483-491 https://doi.org/10.1016/S0304-3959(98)00220-6
  2. Baranowski, T., Cullen, K. W., Nicklas, T., Thompson, D., & Baranowski, J. (2003). Are current health behavioral change models helpful in guiding prevention of weight gain efforts? Obes Res, 11, 23S-43S https://doi.org/10.1038/oby.2003.222
  3. Burke, L.E., & Dunbar-Jacob, J. (1995). Adherence to medication, diet, and activity recommendations: From assessment to maintenance. J Cardiovasc Nurs, 9(2), 62-79
  4. Carlson, J.J., Norman, G.J., Feltz, D.L., Franklin, B.A., Johnson, J.A., & Locke, S.K. (2001). Self-efficacy, psychosocial factors, and exercise behavior in traditional versus modified cardiac rehabilitation. J Cardiopulm Rehabil, 21(6), 363-373 https://doi.org/10.1097/00008483-200111000-00004
  5. Chockalingam, A., Bacher, M., Campbell, N., Cutler, H., Drover, A., Feldman, R., Fodor, G., Irvine, J., Ramsden, V., Thivierge, R., & Tremblay, G. (1998). Adherence to management of high blood pressure: Recommendations of the Canadian coalition for high blood pressure prevention and control. Can J Public Health, 89(5), I5-11
  6. Clark, N.M., & Dodge, J.A. (1999). Exploring self-efficacy as a predictor of disease management. Health Educ Behav, 26(1), 72-89 https://doi.org/10.1177/109019819902600107
  7. Culos-Reed, S.N., Rejeski, W.J., McAuley, E., Ockene, J.K., & Roter, D.L. (2000). Predictors of adherence to behavior change interventions in the elderly. Control Clin Trials, 21, 200S-205S https://doi.org/10.1016/S0197-2456(00)00079-9
  8. Daly, J., Sindone, A.P., Thompson, D.R., Hancock, K., Chang, E., & Davidson, P. (2002). Barriers to participation in and adherence to cardiac rehabilitation programs: A critical literature review. Prog Cardiovasc Nurs, 17(1), 8-17 https://doi.org/10.1111/j.0889-7204.2002.00614.x
  9. Devine, E.C., & Reifschneider, E. (1995). A meta-analysis of the effects of psycho educational care in adults with hypertension. Nurs Res, 44(4), 237-245
  10. DiMatteo, M.R., Lepper, H.S., & Croghan, T.W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med, 160(14), 2101-2107 https://doi.org/10.1001/archinte.160.14.2101
  11. Emanuel, E.J., & Emanuel, L.L. (1992). Four models of the physician-patient relationship. JAMA, 267(16), 2221-2226 https://doi.org/10.1001/jama.267.16.2221
  12. Ewart, C.K. (1991). Social Action Theory for a public health psychology. Am Psychol, 46(9), 931-946 https://doi.org/10.1037/0003-066X.46.9.931
  13. Galassi, J.P., Schanberg, R., & Ware, W.B. (1992). The Patient Reactions Assessment: A brief measure of the quality of the patient-provider medical relationship. Psychol Assess, 4(3), 346-351 https://doi.org/10.1037/1040-3590.4.3.346
  14. Ha, Y.C., Chun, H.J., Hwang, H.K, Kim, B.S., & Kim, J.R. (2000). The prevalence, awareness, treatment, and control of hypertension, and related factors in rural Korea. Korean J Prev Med, 33(4), 513-520
  15. Joreskog, K.G., & Sorbom, D. (1996). LISREL8 user's reference guide. Scientific Sofrware, Chicago: IL
  16. Kerr, J.A. (1985). Adherence and self-care. Heart Lung, 14(1), 24-31
  17. Kim, K.S. (2001). AMOS 4: Analysis structural equation modeling. Seoul: SPSS Academy
  18. Kim, M.T., Hill, M.N., Bone, L.R., & Levine, D.M. (2000). Development and testing of the Hill-Bone Compliance to High Blood Pressure Therapy Scale. Prog Cardiovasc Nurs, 15(3), 90-96 https://doi.org/10.1111/j.1751-7117.2000.tb00211.x
  19. Korean National Statistics Office. (2002). Annual report on the cause of death statistics, from http://kosis.nso.go.kr/juro/index.html
  20. Lee, Y.W. (1995). A study of the effect of an efficacy expectation promoting program on self-efficacy and self-care. J Korean Acad Adult Nurs, 7(2), 212-226
  21. Miller, P., Wikoff, R., & Hiatt, A. (1992). Fishbein's model of reasoned action and compliance behavior of hypertensive patients. Nurs Res, 41(2), 104-109
  22. Morrison-Beedy, D., Carey, M.P., & Lewis, B.P. (2002). Modeling condom-use stage of change in low-income, single, urban women. Res Nurs Health, 25(2), 122-134 https://doi.org/10.1002/nur.10026
  23. Oh, H.S. (1993). Health promoting behaviors and quality of life of Korean women with arthritis. J Korean Acad Nurs, 23(4), 617-630
  24. Park, J.K., Kim, C.B., Kim, K.S., Kang, M.G., & Jee, S.H. (2001). Meta-analysis of hypertension as a risk factor of cerebrovascular disorders in Koreans. J Korean Med Sci, 16(1), 2-8
  25. Radloff, L.S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Appl Psychol Meas, 1(3), 385-401 https://doi.org/10.1177/014662167700100306
  26. Schoenberg, N.E. (1998). The relationship between perceptions of social support and adherence to dietary recommendations among African-American elders with hypertension. Int J Aging Hum Dev, 47(4), 279-297 https://doi.org/10.2190/0L2Y-FXVE-KJYH-318A
  27. Shah, S., & Cook, D.G. (2001). Inequalities in the treatment and control of hypertension: Age, social isolation and lifestyle are more important than economic circumstances. J Hypertens, 19, 1333-1340 https://doi.org/10.1097/00004872-200107000-00020
  28. Sherbourne, C.D., & Stewart, A.L. (1991). The MOS social support survey. Soc Sci Med, 32(6), 705-714 https://doi.org/10.1016/0277-9536(91)90150-B
  29. Sherer, M., Maddux, J.E., Mercandante, B., Prentice-Dunn, S., Jacobs, B., & Rogers, R.W. (1982). The Self-Efficacy Scale: Construction and Validation. Psychol Rep, 51, 663-671 https://doi.org/10.2466/pr0.1982.51.2.663
  30. Stanton, A.L. (1987). Determinants of adherence to medical regimens by hypertensive patients. J Behav Med, 10, 377-394 https://doi.org/10.1007/BF00846477
  31. Taylor, C.B., Bagozzi, R.P., & Gaither, CA. (2001). Gender differences in the self-regulation of hypertension. J Behav Med, 24(5), 469-487 https://doi.org/10.1023/A:1012223627324
  32. Wang, P.S., Bohn, R.L., Knight, E., Glynn, R.J., Mogun, H., & Avorn, J. (2002). Noncompliance with antihypertensive medications: The impact of depressive symptoms and psychosocial factors. J Gen Intern Med, 17(7), 504-511 https://doi.org/10.1046/j.1525-1497.2002.00406.x