| ObjectiveThe study's objective were to understand the status of medication adherence in the elderly patients with comorbidity and to explore the influencing factors from the general information,regulatory emotional self-efficacy,cognitive emotion regulation strategies,the beliefs about medication,self-perceived burden.Of course,it also studyed the mediating role of cognitive emotion regulation strategies and regulatory emotional self-efficacy between self perceived burden and medication adherence.The target was to provide the theoretical basis of psychological intervention for medical staffs and family members of patients.Furthermore,it can also improve the level of medication adherence and achieve effective management of community disease.MethodsFirst,we consulted the related literature of Chinese journal network database and analyzed the possible influencing factors of the medication adherence in community elderly patients with comorbidity.According to it,we designed the questionnaire about the general demographic status and disease related factors.Then,a survey was conducted among 399 old men in 9 communities in Kaifeng from November 2016 to April 2017 by using the general information questionnaire,chronic disease medication adherence scale,regulatory emotional self-efficacy scale(RES),cognitive emotion regulation questionnaire(CERQ),the beliefs about medication questionnaire(BMQ)and the self-perceived burden scale(SPBS).Finally,the database was built by Epidata3.1 software.And descriptive statistics analysis,one-way ANOVA,Pearson correlation analysis,Bootstrap mediating effect test and multiple linear regression analysis were performed by SPSS17.0 software.Results1.The status of medication adherence in the elderly patients with comorbidityThe the elderly patients with comorbidity got medication adherence score66.40 + 9.55.Especially,the behavioral performance score was 43.35 + 7.14 and healthy beliefs score was23.05 + 3.17.There were 41 cases with bad compliance(10.3%)and 116 cases with general compliance(29.1%)and 242 cases with good compliance(60.6%).2.Thesingle factor analysis of general information on medication adherence in community elderly patients with comorbidityUnivariate analysis showed that the age,residence,educational level,occupation before retirement,family income,payment method of medical expenses,the annual number of chronic disease recurrence,the number of hospitalization due to chronic disease were important influencing factors about medication adherence.The difference was statistically significant(P<0.05).3.The correlation analysis between regulatory emotional self-efficacy,cognitive emotion regulation strategies,the beliefs about medication,self perceived burden and medication adherence in community elderly patients with comorbidityThe score of regulatory emotional self-efficacy was 38.47+ 6.93,which was correlated with medication adherence(r=0.541,P<0.01).The scores of the other dimensions were correlated with medication adherence(P<0.01)but not including the first dimension.And the correlation coefficients were 0.551 and 0.499,respectively.The score of cognitive emotion regulation strategies was 119.56 + 11.66,which its correlation coefficients was 0.464.The other seven dimensions were related with medication adherence in addition to self blame and blame others.It had positive correlation with adaptive emotion regulation strategies(r=0.575,P<0.01)and it had negative correlation with non-adaptive emotion regulation strategies(r=-0.106,P<0.05).The total score of beliefs about medication was 5.78 + 4.37.It had correlation with medication adherence(r=0.305,P<0.01),which had statistical significance with necessity of taking medication(r=0.326,P<0.01)and scruples of taking medication(r=-0.116,P>0.05).The total score of self-perceived burden was 27.51 + 8.10,which was correlated with medication adherence(r=-0.416,P<0.01).And the scores of three dimension were negatively correlated with medication adherence(P<0.01).Its correlation coefficients were-0.327,-0.377and-0.392,respectively.4.Multiple factors analysis of medication adherence in community elderly patients with comorbidityWe regarded medication adherence as the dependent variable,at the same time,we regarded the variables with statistical significance in the above statistical analysis as the independent variables,and multiple stepwise regression analysis was carried out.The results showed that cognitive emotion regulation strategies,regulatory emotional self-efficacy,residence,beliefs about medication,self perceived burden,age and the annual number of chronic diseases recurrence had an effect on medication adherence.The difference was statistically significant(P<0.05).5.the mediating effect of cognitive emotion regulation strategies and regulatory emotional self-efficacySelf-perceived burden influenced regulatory emotional self-efficacy through cognitive emotion regulation strategies and then it influenced medication adherence with indirect effect value of-0.273(P<0.05).It can also influence the medication adherence directly by cognitive emotion regulation strategies.Even it can also influence the medication adherence through regulatory emotional self-efficacy.The total effect value of the mediating effect was-0.490 and the direct effect value was-0.218.conclusion1.The medication adherence of the elderly patients with comorbidity is goodl,butit's adherence level also needs to be further improved.2.Cognitive emotion regulation strategies,regulatory emotional self-efficacy,residence,beliefs about medication,self perceived burden,age and the annual number of chronic disease recurrence are the significant factors that influence the medication adherence of the patients.3.The cognitive emotion regulation strategies and regulatory emotional self-efficacy play a mediating role between the self-perceived burden and the adherence of the medication. |
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