The multidimensional impact mechanism of treatment convenience, threat assessment, and coping evaluation on medication adherence in pediatric epilepsy patients

Purpose

This study constructs a multidimensional impact mechanism model of “treatment convenience → threat assessment → coping evaluation → medication adherence,” systematically revealing the various factors affecting medication adherence in pediatric epilepsy.

Methods

This cross-sectional study selected pediatric epilepsy patients and their caregivers from three institutions: West China Second University Hospital (Jinjiang and West China campuses) and Sichuan Provincial Children’s Hospital. Data were collected through a questionnaire survey. Based on Protection Motivation Theory (PMT), a Structural Equation Model (SEM) was constructed to verify the relationships among treatment convenience, threat assessment, coping evaluation, and medication adherence, test the related theoretical hypotheses, and further analyze the mediating roles of threat assessment and coping evaluation in the relationship between treatment convenience and medication adherence.

Results

A total of 874 patients were included, with an average age of 8.85 ± 3.98 years. Among the different types of epilepsy, focal/partial seizures were the most common, accounting for 47.7 % (417 cases). The medication adherence score was 3.275 ± 1.264, the treatment convenience score was 26.783 ± 6.724, the threat assessment score was 42.013 ± 10.817, and the coping evaluation score was 34.719 ± 8.651. Significant positive correlations were found between all three scores. The reliability and validity of all scales were good. Path analysis revealed that treatment convenience, threat assessment, and coping evaluation all had a significant positive impact on medication adherence. Mediating effect analysis showed that the effect of treatment convenience on medication adherence was both direct and indirect, mediated by threat assessment and coping evaluation.

Conclusion

Treatment convenience affects medication adherence through both direct and mediating pathways, while threat assessment and coping evaluation have profound impacts on adherence at both cognitive and behavioral levels. Future clinical practice should focus on optimizing external conditions (such as improving treatment convenience) and internal psychological interventions (such as appropriately guiding threat perception and enhancing coping strategies) to improve patient adherence from multiple dimensions, providing scientific support for the long-term management of pediatric epilepsy.