Mental health and adherence in CF: Self-efficacy and perceived barriers as mediators

IF 5.4 2区医学 Q1 RESPIRATORY SYSTEM

Journal of Cystic Fibrosis Pub Date : 2025-03-01 DOI:10.1016/j.jcf.2025.02.016

Robin S. Everhart , Milene T. Saavedra , Christine R. Ford , Sidney L. Gibson , Felicia Reid , Emily F. Muther , Christina L. Duncan , Rachel Cravens , Angela Green , Kristin A. Riekert

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引用次数: 0

Abstract

Background

Symptoms of depression and anxiety can contribute to lower medical treatment adherence. Given that people with cystic fibrosis (PWCF) have higher rates of depressive and anxiety symptoms than those without cystic fibrosis (CF), this study examined factors that mediated the association between mental health and adherence.

Methods

Participants were 294 adults (M age=25 years) with CF who were enrolled in the Daily Care Check-in Validation Study. Participants completed in-clinic questionnaires that assessed depressive and anxiety symptoms, perceived barriers to self-management, and medication self-efficacy. Medication adherence was measured by pharmacy refill data. Parallel mediation models assessed perceived barriers and medication self-efficacy as mediators between depressive symptoms and adherence, and between anxiety symptoms and adherence.

Results

Perceived interference of barriers to self-management significantly mediated the association between depressive symptoms and adherence (β =-0.005, SE=0.002, 95 % CI [-0.009, -0.001]), and between anxiety symptoms and adherence (β=-0.005, SE=0.003, 95 % CI [-0.008, -0.001]). Additionally, self-efficacy significantly mediated the association between depressive symptoms and adherence (β=-0.004, SE=0.001, 95 % CI [-0.007, -0.002]), and between anxiety symptoms and adherence (β=-0.004, SE=0.001, 95 % CI [-0.007, -0.001]).

Conclusions

This study found that when PWCF experienced mental health symptoms (either anxiety or depression), they were likely to report more interference from barriers to disease management or experience less medication self-efficacy, which was related to worse adherence. Building self-efficacy around taking medications may reduce the impact that mental health symptoms have on adherence. Care teams should also work with PWCF to minimize the impact of barriers on daily therapies.

查看原文本刊更多论文

CF患者的心理健康和依从性：自我效能感和感知障碍作为中介。

背景：抑郁和焦虑症状可能导致较低的药物依从性。考虑到患有囊性纤维化（PWCF）的人比没有囊性纤维化（CF）的人有更高的抑郁和焦虑症状，本研究检查了介导心理健康和依从性之间关联的因素。方法：参与者是294名CF患者（M年龄=25岁），他们参加了日常护理登记验证研究。参与者完成了评估抑郁和焦虑症状、感知到的自我管理障碍和药物自我效能的门诊问卷。药物依从性通过药房再填充数据来衡量。平行中介模型评估了感知障碍和药物自我效能在抑郁症状和依从性之间以及焦虑症状和依从性之间的中介作用。结果：自我管理障碍的感知干扰显著介导了抑郁症状和依从性之间的关联（β=-0.005， SE=0.002, 95% CI[-0.009, -0.001]），以及焦虑症状和依从性之间的关联（β=-0.005， SE=0.003, 95% CI[-0.008, -0.001]）。此外，自我效能显著介导抑郁症状与依从性之间的关联（β=-0.004， SE=0.001, 95% CI[-0.007, -0.002]），以及焦虑症状与依从性之间的关联（β=-0.004， SE=0.001, 95% CI[-0.007, -0.001]）。结论：本研究发现，当PWCF出现心理健康症状（焦虑或抑郁）时，他们可能会报告更多来自疾病管理障碍的干扰，或者经历更少的药物自我效能感，这与更差的依从性有关。围绕服药建立自我效能感可能会减少心理健康症状对服药依从性的影响。护理团队还应与PWCF合作，尽量减少障碍对日常治疗的影响。

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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来源期刊

Journal of Cystic Fibrosis 医学-呼吸系统

CiteScore

10.10

自引率

13.50%

发文量

1361

审稿时长

50 days

期刊介绍： The Journal of Cystic Fibrosis is the official journal of the European Cystic Fibrosis Society. The journal is devoted to promoting the research and treatment of cystic fibrosis. To this end the journal publishes original scientific articles, editorials, case reports, short communications and other information relevant to cystic fibrosis. The journal also publishes news and articles concerning the activities and policies of the ECFS as well as those of other societies related the ECFS.