The Effects Of The Uncertainty In Illness,Family Care And Resilience On Drug Compliance Among Patients With Systemic Lupus Erythematosus

Objective: Systemic lupus erythematosus(SLE)is a long-term,recurrent disease,whose treatment relies on drugs for a long time.The process of medication taking and disease control of SLE are chronic,which require patients to have good self-management behavior and medication compliance.Therefore,this study aims to explore the prevalence of the drug compliance in SLE patients,and focuses on the relationship among family care,uncertainty in illness,resilience and drug compliance.According to the results,the intervention strategies to improve the drug compliance of SLE patients were provided for improving the management of SLE and improving its prognosis and quality of life of patients.Methods: In this study,SLE patients in Shengjing Hospital of Liaoning Province were selected by convenience sampling to complete self-administered questionnaires which included general characteristics questionnaire,uncertainty in illness Scale(MUIS),family care scale(APGAR),resilience scale(CD-RISC)and medication compliance scale(MMAS-8)to assess the general characteristics,disease uncertainty,family care,resilience and medication compliance of SLE patients.Out of 250 questionnaires,206 effective questionnaires were collected,with an effective rate of 82.4%.One way ANOVA and t-test were used to compare the differences of drug compliance among SLE patients in different general characteristics;Pearson correlation analysis was used to evaluate the correlation between drug compliance and its related factors;hierarchical regression analysis was used to explore the effects of influencing factors of drug compliance,and to explore whether the resilience mediates the relationships between drug compliance and its related factors(disease uncertainty and family care).The structural equation model was used to verify the mediating effect of resilience.Results: The average score of compliance of SLE patients was 4.39 ± 2.57,of which 116(56.3%)SLE patients were shown to have low drug compliance.Economic burden and relapse times of SLE might be the influencing factors of drug compliance in SLE patients.After excluding the control factors,uncertainty in disease and family care were the important factors of medication compliance,which explained 21.9% and 27.8% of the variation of medication compliance,respectively.The higher the resilience of patients,the higher their drug compliance.Structural equation model fitted well,indicating that resilience played partly mediating roles in the relationship between medication compliance and its related factors: disease uncertainty and family care.Conclusion: The poor drug compliance of SLE patients has not been improved compared with the past.Patient’s uncertainty in illness and family care were the key factors affecting medication compliance.Resilience were an important positive psychological resource to promote patient’s medication compliance and it played partly mediating roles in the relationships between medication compliance and its related factors.Health authorities should take measures such as adjusting drug prices,reduce the disease uncertainty of SLE patients by carrying out health education and implementing humanistic care strategies,attach importance to the crucial effect of family care on SLE patients’ drug compliance and make SLE patients master positive coping strategies,mindfulness training and so on to improve the level of resilience of SLE patients for improving the medication compliance,prognosis and quality of life of them.