Pathways Linking Parental Social Support and Decision-Making Participation to Medication Adherence in Children With Epilepsy: The Moderating Role of Parental Anxiety

IF 3.3 2区医学 Q1 PSYCHIATRY

Depression and Anxiety Pub Date : 2025-09-16 DOI:10.1155/da/7159579

Chunsong Yang, Rui Huang, Qiuji Tao, Zilong Hao, Li Zhao, Lingli Zhang

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Abstract

Background: Medication adherence among pediatric epilepsy patients is frequently suboptimal, and the complex interplay between parental social support, decision-making participation, treatment satisfaction, and parental anxiety in influencing medication adherence remains underexplored. This study investigates both the direct and indirect pathways linking these factors to medication adherence and examines the mediating role of treatment satisfaction and the moderating role of parental anxiety.

Methods: A cross-sectional study was conducted at three medical institutions between January 2020 and June 2024. Data on patient demographics and standardized scales measuring medication adherence, social support, communication and decision-making participation, treatment satisfaction, and parental anxiety were collected. Relationships among these variables were analyzed using structural equation modeling (SEM) and moderation analysis.

Results: A total of 1056 patients were included in the study, with a mean age of 8.86 ± 3.99 years; 51.7% were male. Path analysis showed that parental social support (STD = 0.344, p < 0.001), communication and decision-making participation (STD = 0.392, p < 0.001), and treatment satisfaction (STD = 0.090, p < 0.05) had significant positive effects on medication adherence. Parental social support (STD = 0.483, p < 0.001) and communication and decision-making participation (STD = 0.203, p < 0.001) also strongly influenced treatment satisfaction. The indirect effects of social support and decision-making participation on medication adherence, mediated through treatment satisfaction, were statistically significant (p < 0.05). Parental anxiety, as a moderating factor, weakened the positive effects of social support, decision-making participation, and treatment satisfaction on medication adherence (p < 0.05).

Conclusion: This study systematically develops an integrated model linking parental social support, communication and decision-making participation, treatment satisfaction, and anxiety to medication adherence in pediatric epilepsy. It highlights the mediating role of treatment satisfaction and the moderating role of parental anxiety. Enhancing parental social support and communication, improving treatment satisfaction, and addressing parental anxiety are key strategies to promote medication adherence.

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父母社会支持和决策参与对癫痫儿童药物依从性的影响：父母焦虑的调节作用

背景：儿童癫痫患者的药物依从性经常是次优的，父母社会支持、决策参与、治疗满意度和父母焦虑之间影响药物依从性的复杂相互作用仍未得到充分研究。本研究探讨了这些因素对药物依从性的直接和间接影响，并探讨了治疗满意度的中介作用和父母焦虑的调节作用。方法：于2020年1月至2024年6月在三家医疗机构进行横断面研究。收集患者人口统计数据和测量药物依从性、社会支持、沟通和决策参与、治疗满意度和父母焦虑的标准化量表。利用结构方程模型（SEM）和调节分析分析了这些变量之间的关系。结果：共纳入1056例患者，平均年龄8.86±3.99岁；51.7%为男性。通径分析显示，父母社会支持（STD = 0.344, p < 0.001）、沟通与决策参与（STD = 0.392, p < 0.001）、治疗满意度（STD = 0.090, p < 0.05）对患儿服药依从性有显著正向影响。父母社会支持（STD = 0.483, p < 0.001）和沟通决策参与（STD = 0.203, p < 0.001）对治疗满意度也有显著影响。社会支持和决策参与通过治疗满意度间接影响药物依从性，差异有统计学意义（p < 0.05）。父母焦虑作为调节因素，削弱了社会支持、决策参与和治疗满意度对药物依从性的正向影响（p < 0.05）。结论：本研究系统地建立了儿童癫痫患者父母社会支持、沟通和决策参与、治疗满意度和焦虑与药物依从性之间的综合模型。强调治疗满意度的中介作用和父母焦虑的调节作用。加强父母的社会支持和沟通，提高治疗满意度，解决父母的焦虑是促进药物依从性的关键策略。

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来源期刊

Depression and Anxiety 医学-精神病学

CiteScore

15.00

自引率

1.40%

发文量

审稿时长

4-8 weeks

期刊介绍： Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.