Family Size Effect on Mental Health and medication Adherence on a Sample of Copd Patients. The Moderating Role of Financial Strain

Abstract

Aim: The aim of the study is to evaluate the family size and the financial strain effects on medication adherence, testing in particular the hypothesis that mental health mediates the relation between family size and medication adherence. Methods: The results of the study are based on a purposive sample of 105 COPD patients (94 male, 11 female) with an average age of 68.9 (SD = 9.2). The participants completed the 8-Item Morisky Medication Adherence Scale (MMAS-8) and the 36-item Short Form health survey (SF-36) from which their medication-taking behavior and their mental health was evaluated. Further, they were asked to complete a sociodemographic questionnaire including self-evaluation items about their current financial situation and the impact of the economic crisis on family, health, and treatment. A path analysis approach was used to test the indirect effect of family size on medication adherence and the moderating role of impact and mortgage debt, controlling for age, duration of COPD illness, and income of the respondents. Results: Financial health, as is reflected in the monthly income and an obligation to repay a mortgage debt was found to be positively associated with medication adherence. The impact of the financial crisis was significantly associated with mental health for the patients that experienced parenthood in families with 2 or more children. Not an analogous effect was reported for patients having been parents of one child or no children. That is, the family size effect on mental health is moderated by the impact of the financial crisis. No significant effect on mental health was reported on medication adherence. Further, neither age nor illness duration was found to have a significant effect on both mental health and adherence. Conclusions: Financial health is confirmed to be positively related to medication adherence. The hypothesized mediating role of mental health in the relation between family size and adherence is not confirmed. Having been a parent of a large family is associated with a greater vulnerability to the effects of financial strain on mental health in the long run.