TitleAffective distress moderates the relationship between treatment beliefs and adherence in chronic illness patients
NameHeld, Rachel Forster (author), Leventhal, Howard (chair), McCarthy, Danielle (internal member), Contrada, Richard (internal member), Leventhal, Elaine (outside member), Rutgers University, Graduate School - New Brunswick,
Chronic diseases--Psychological aspects,
DescriptionIn chronic illness patients, nonadherence to prescribed medical regimens is common. Many factors can contribute to nonadherence, including depressive
symptoms and patient perceptions of treatment. Having fewer depressive symptoms often predicts better adherence, as do three types of treatment perceptions: stronger belief in one’s ability to adhere to treatment, stronger belief that the treatment will be effective, and greater concerns about the treatment. However, these predictors are rarely examined together, and individually they often predict only a small amount of variance in adherence. The current study investigates treatment perceptions and affective distress as predictors of adherence in a sample of 102 primary care patients. Participants had newly prescribed treatments for problems related to a chronic condition. Interview data
was collected after doctor visits and one month later. It was hypothesized that the three treatment variables – believing treatment would be easy to do, having concerns about the treatment, and believing it would be effective – would predict adherence to medical
regimens. It was also hypothesized that affective distress, as measured by the mental health (MH) subscale of the SF-12, would moderate the effects of treatment perception. Patients with poor MH scores were expected to show better adherence only if they believed the treatment would be effective and easy to do, and they had few treatment-related concerns. Believing treatment would be effective predicted adherence, and having concerns about treatment approached significance, while perceived ease of treatment did not. Moderation was seen for one of the three expected interactions; belief in the treatment’s ability to control the problem predicted adherence for patients with low but not high MH scores. A possible explanation is that patients with fewer depressive
symptoms may be more hopeful and motivated to try treatments, even if they are less sure the treatments will be effective. Findings support the importance of doctors
addressing patients’ confidence in treatment effectiveness, and of screening for depression not only to address depressive symptoms themselves but also to determine which patients may require more discussion of prescribed treatments.
NoteIncludes bibliographical references
Noteby Rachel Forster Held
CollectionGraduate School - New Brunswick Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.