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{"title":"A Cross-Sectional Study of Cognitive Function, Illness Perceptions, and Immunosuppression Medication Adherence After Heart Transplantation.","authors":"Stacy Al-Saleh, Samantha Conley, Thaddeus Pace, Kathleen C Insel","doi":"10.1177/01939459231220283","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There are few studies that examine relationships between cognitive function, illness perceptions, and medication adherence after heart transplantation, limiting the development of effective adherence-promoting interventions.</p><p><strong>Objective: </strong>The purpose of this study was to describe relationships between cognitive function, illness perceptions, and medication adherence among heart transplant recipients.</p><p><strong>Methods: </strong>A cross-sectional, observational design was used. Measures included the telephone-Montreal Cognitive Assessment (t-MoCA©), Patient Health Questionnaire-9, Brief Test of Adult Cognition by Telephone, Basel Assessment of Adherence to Immunosuppressive Medications Scale, and the Brief Illness Perceptions Questionnaire. Descriptive statistics, point-biserial correlations, Pearson's correlations, and logistic regression were used to describe relationships.</p><p><strong>Results: </strong>Of the 35 participants (mean age: 61 years [SD: 10.3], 71.4% male, 71.4% white), 31.4% (n = 11) were classified as nonadherent to their immunosuppression medications. Higher immediate word recall, indicating better episodic memory (memory for autobiographical and recent events), and higher illness coherence scores were associated with not missing doses of medication. Higher t-MoCA© total scores, indicating normal cognitive function, and lower depression scores were associated with taking medications on time. More than 22% (n = 8) of participants scored less than 19 on the t-MoCA©, an indication of mild cognitive impairment.</p><p><strong>Conclusion: </strong>Cognitive impairment may be more common among heart transplant recipients than what is currently recognized, and specific domains of cognitive function were related to medication adherence after transplantation in this study. Future studies should include longitudinal evaluations of cognitive function, depression, and medication adherence. Consideration of these relationships is needed when designing adherence-promoting interventions for this population.</p>","PeriodicalId":49365,"journal":{"name":"Western Journal of Nursing Research","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Western Journal of Nursing Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/01939459231220283","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/12/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
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Abstract
Background: There are few studies that examine relationships between cognitive function, illness perceptions, and medication adherence after heart transplantation, limiting the development of effective adherence-promoting interventions.
Objective: The purpose of this study was to describe relationships between cognitive function, illness perceptions, and medication adherence among heart transplant recipients.
Methods: A cross-sectional, observational design was used. Measures included the telephone-Montreal Cognitive Assessment (t-MoCA©), Patient Health Questionnaire-9, Brief Test of Adult Cognition by Telephone, Basel Assessment of Adherence to Immunosuppressive Medications Scale, and the Brief Illness Perceptions Questionnaire. Descriptive statistics, point-biserial correlations, Pearson's correlations, and logistic regression were used to describe relationships.
Results: Of the 35 participants (mean age: 61 years [SD: 10.3], 71.4% male, 71.4% white), 31.4% (n = 11) were classified as nonadherent to their immunosuppression medications. Higher immediate word recall, indicating better episodic memory (memory for autobiographical and recent events), and higher illness coherence scores were associated with not missing doses of medication. Higher t-MoCA© total scores, indicating normal cognitive function, and lower depression scores were associated with taking medications on time. More than 22% (n = 8) of participants scored less than 19 on the t-MoCA©, an indication of mild cognitive impairment.
Conclusion: Cognitive impairment may be more common among heart transplant recipients than what is currently recognized, and specific domains of cognitive function were related to medication adherence after transplantation in this study. Future studies should include longitudinal evaluations of cognitive function, depression, and medication adherence. Consideration of these relationships is needed when designing adherence-promoting interventions for this population.
一项关于心脏移植后认知功能、疾病认知和免疫抑制药物依从性的横断面研究。
背景：很少有研究探讨心脏移植后认知功能、疾病认知和服药依从性之间的关系，这限制了有效的促进依从性干预措施的发展：本研究旨在描述心脏移植受者的认知功能、疾病认知和服药依从性之间的关系：方法：采用横断面观察设计。测量方法包括电话蒙特利尔认知评估（t-MoCA©）、患者健康问卷-9、电话成人认知能力简测、免疫抑制药物治疗依从性巴塞尔评估量表和疾病认知简测问卷。采用描述性统计、点-线性相关、皮尔逊相关和逻辑回归来描述相关关系：在 35 名参与者（平均年龄：61 岁[SD：10.3]，71.4% 为男性，71.4% 为白人）中，31.4%（n = 11）被归类为不坚持服用免疫抑制药物。较高的即时单词回忆能力（表明较好的外显记忆（对自传体和近期事件的记忆））和较高的疾病连贯性得分与不漏服药物有关。较高的 t-MoCA© 总分（表明认知功能正常）和较低的抑郁得分与按时服药有关。超过 22% 的参与者（n = 8）在 t-MoCA© 中的得分低于 19 分，这表明存在轻度认知障碍：结论：认知功能障碍在心脏移植受者中的常见程度可能高于目前的认知水平，在本研究中，认知功能的特定领域与移植后的服药依从性有关。未来的研究应包括对认知功能、抑郁和服药依从性的纵向评估。在为这一人群设计促进依从性的干预措施时，需要考虑到这些关系。
本文章由计算机程序翻译，如有差异，请以英文原文为准。
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