Biing-Jiun Shen1,2, Uta Maeda3. 1. Division of Psychology, Nanyang Technological University, Singapore. 2. Department of Psychological and Brain Sciences, University of Delaware, Newark, DE. 3. Department of Psychology, University of Southern California, Los Angeles, CA.
Abstract
Background: Poor adherence to medical regimens is a serious problem that interferes with heart failure (HF) patients' disease management and contributes to poor clinical outcomes. Few prospective studies have examined the psychosocial predictors of adherence over time in HF patients. Purpose: This study examined the influences of depression, self-efficacy, social support, and their changes on self-reported medical adherence over 6 months in HF patients. Methods: Participants were 252 HF outpatients, among whom 168 completed follow-up assessments. Hierarchical multiple regression analyses were conducted to examine whether psychosocial variables and their changes prospectively predicted adherence at 6 months, after adjusting for baseline adherence, age, gender, ethnicity, marital status, education, HF severity, medical comorbidity, and mental health treatment. Results: Baseline self-efficacy (β = .22, p < .05), increase in self-efficacy (β = .34, p < .001), and decrease in depression (β = -.15, p = .05) predicted improved adherence over 6 months, but social support did not. In the combined model that included all significant psychosocial predictors from previous analyses, baseline self-efficacy (β = .37, p = .001) and its increase (β = .35, p < .001) emerged as independent predictors of improved adherence at 6 months. Conclusions: Promoting self-efficacy and reducing depressive symptoms may be promising targets of behavioral interventions to facilitate long-term disease management in HF patients.
Background: Poor adherence to medical regimens is a serious problem that interferes with heart failure (HF) patients' disease management and contributes to poor clinical outcomes. Few prospective studies have examined the psychosocial predictors of adherence over time in HF patients. Purpose: This study examined the influences of depression, self-efficacy, social support, and their changes on self-reported medical adherence over 6 months in HF patients. Methods:Participants were 252 HF outpatients, among whom 168 completed follow-up assessments. Hierarchical multiple regression analyses were conducted to examine whether psychosocial variables and their changes prospectively predicted adherence at 6 months, after adjusting for baseline adherence, age, gender, ethnicity, marital status, education, HF severity, medical comorbidity, and mental health treatment. Results: Baseline self-efficacy (β = .22, p < .05), increase in self-efficacy (β = .34, p < .001), and decrease in depression (β = -.15, p = .05) predicted improved adherence over 6 months, but social support did not. In the combined model that included all significant psychosocial predictors from previous analyses, baseline self-efficacy (β = .37, p = .001) and its increase (β = .35, p < .001) emerged as independent predictors of improved adherence at 6 months. Conclusions: Promoting self-efficacy and reducing depressive symptoms may be promising targets of behavioral interventions to facilitate long-term disease management in HF patients.
Authors: Seongkum Heo; Terry A Lennie; Debra K Moser; Sandra B Dunbar; Susan J Pressler; JinShil Kim Journal: Geriatr Nurs Date: 2022-01-29 Impact factor: 2.361