Journal of Korean Clinical Nursing Research (임상간호연구)

Hospital Nurses Association (병원간호사회)
권호 표지
DOI QR코드

DOI QR Code

Impact of Depression on Medication Adherence of Patients with Systemic Lupus Erythematosus: Focusing on Mediating Effect of Self-Efficacy and Belief about Medication

전신성 홍반성 루푸스 환자의 우울이 복약순응도에 미치는 영향: 자기효능감과 약물에 대한 신념의 매개 효과를 중심으로

  • Lee, Su Jin (Department of Nursing, Dong-A University Hospital.Department of Nursing, Dong-A University) ;
  • Ju, Hyeon Ok (Department of Nursing, Dong-A University)
  • 이수진 (동아대학교병원 간호사.동아대학교 간호학과) ;
  • 주현옥 (동아대학교 간호학과)
  • Received : 2019.05.30
  • Accepted : 2019.06.24
  • Published : 2019.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to determine the mediating effects of self-efficacy and the belief about medication on the association between depression and medication adherence in patients with systemic lupus erythematosus. Methods: 128 patients aged ${\geq}19years$, who were regular outpatients or admitted patients diagnosed with systemic lupus erythematosus at a tertiary hospital in B city, participated in this study. Data were collected by using a self-administered questionnaire. Testing of mediating effects was analyzed by a parallel redundant mediated model using the PROCESS macro for SPSS version 3.3. Results: They scored an average of $16.71{\pm}11.13$ for depression, $694.14{\pm}170.68$ for self-efficacy, $3.05{\pm}4.60$ for the belief about medication, and $90.14{\pm}15.37$ for medication adherence. The direct effect of depression on medication adherence was not statistically significant, but the indirect effects of depression mediated with self-efficacy and belief about medication were statistically significant. Conclusion: It is necessary to develop and apply a nursing intervention program that can not only relieve depression but also promote self-efficacy and the belief about medication with the objective of improving medication adherence among patients with systemic lupus erythematosus.

Keywords

References

  1. Hahn BH. Systemic lupus erythematosus. In: Fauci AS, Langford CA, editors. Harrison's rheumatology. 3rd ed. New York: McGraw-Hill; 2013. p. 68-83.
  2. Choi JJ. Current clinical practice: Diagnosis and treatment of systemic lupus erythematosus. The Korean Journal of Medicine. 2010;78(4):437-443.
  3. Alsowaida N, Alrasheed M, Mayet A, Alsuwaida A, Omair MA. Medication adherence, depression and disease activity among patients with systemic lupus erythematosus. Lupus. 2018;27(2):327-332. https://doi.org/10.1177/0961203317725585
  4. Marengo MF, Waimann CA, de Achaval S, Zhang H, Garcia-Gonzalez A, Richardson MN, et al. Measuring therapeutic adherence in systemic lupus erythematosus with electronic monitoring. Lupus. 2012;21(11):1158-1165. https://doi.org/10.1177/0961203312447868
  5. Julian LJ, Yelin E, Yazdany J, Panopalis P, Trupin L, Criswell LA, et al. Depression, medication adherence, and service utilization in systemic lupus erythematosus. Arthritis Care & Research. 2009;61(2):240-246. https://doi.org/10.1002/art.24236
  6. Kozora E, Ellison MC, Waxmonsky JA, Wamboldt FS, Patterson TL. Major life stress, coping styles, and social support in relation to psychological distress in patients with systemic lupus erythematosus. Lupus. 2005;14(5):363-372. https://doi.org/10.1191/0961203305lu2094oa
  7. Howard P. December's topic of the month-coping with depression and anxiety [Internet]. Romford: Lupus UK; 2017 [cited 2019 January 15]. Available from: https://www.lupusuk.org.uk/coping-with-depression-andanxiety.
  8. Park JW, Kim DH, Suh YS, Kim JB, Lee GH. Drug compliance according to severity of depressive symptoms in medically ill outpatients. Korean Journal of Health Promotion. 2007;7(1):39-44.
  9. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine. 2000;160(14):2101-2107. https://doi.org/10.1001/archinte.160.14.2101
  10. Duvdevany I, Cohen M, Minsker-Valtzer A, Lorber M. Psychological correlates of adherence to self-care, disease activity and functioning in persons with systemic lupus erythematosus. Lupus. 2011;20(1):14-22. https://doi.org/10.1177/0961203310378667
  11. Mosley-Williams A, Lumley MA, Gillis M, Leisen J, Guice D. Barriers to treatment adherence among African American and white women with systemic lupus erythematosus. Arthritis Care & Research. 2002;47(6):630-638. https://doi.org/10.1002/art.10790
  12. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review. 1977;84(2):191-215. https://doi.org/10.1037/0033-295X.84.2.191
  13. Chao J, Nau DP, Aikens JE, Taylor SD. The mediating role of health beliefs in the relationship between depressive symptoms and medication adherence in persons with diabetes. Research in Social and Administrative Pharmacy. 2005;1(4):508-525. https://doi.org/10.1016/j.sapharm.2005.09.002
  14. Hilliard ME, Eakin MN, Borrelli B, Green A, Riekert KA. Medication beliefs mediate between depressive symptoms and medication adherence in cystic fibrosis. Health Psychology. 2015; 34(5):496-504. https://doi.org/10.1037/hea0000136
  15. Horne R, Weinman J. Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. Journal of Psychosomatic Research. 1999;47(6):555-567. https://doi.org/10.1016/S0022-3999(99)00057-4
  16. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1(3):385-401. https://doi.org/10.1177/014662167700100306
  17. Chon KK, Choi SC, Yang BC. Integrated adaptation of CES-D in Korea. Korean Journal of Health Psychology. 2001;6(1):59-76.
  18. Sherer M, Maddux JE, Mercandante B, Prentice-Dunn S, Jacobs B, Rogers RW. The self-efficacy scale: Construction and validation. Psychological Reports. 1982;51(2):663-671. https://doi.org/10.2466/pr0.1982.51.2.663
  19. Oh PJ. A model for health promoting behaviors and quality of life in people with stomach cancer [dissertation]. Seoul: Seoul National University; 1994. p. 1-164.
  20. Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health. 1999;14(1):1-24. https://doi.org/10.1080/08870449908407311
  21. Kim Y, Min YH. Validity and reliability of the Korean version of the Beliefs about Medicines Questionnaire: Specific for breast cancer patients on hormone therapy. Journal of Health Informatics and Statistics. 2017;42(2):136-143. https://doi.org/10.21032/jhis.2017.42.2.136
  22. de Klerk E, van der Heijde D, van der Tempel H, van der Linden S. Development of a questionnaire to investigate patient compliance with antirheumatic drug therapy. The Journal of Rheumatology. 1999;26(12):2635-2641.
  23. de Klerk E, van der Heijde D, Landewe R, van der Tempel H, van der Linden S. The Compliance-Questionnaire-Rheumatology compared with electronic medication event monitoring: A validation study. The Journal of Rheumatology. 2003;30(11):2469-2475.
  24. Lee JY, Lee SY, Hahn HJ, Son IJ, Hahn SG, Lee EB. Cultural adaptation of a compliance questionnaire for patients with rheumatoid arthritis to a Korean version. The Korean Journal of Internal Medicine. 2011;26(1):28-33. https://doi.org/10.3904/kjim.2011.26.1.28
  25. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Lee HK, translator. Seoul: Shinyoungsa; c2015. p. 112-144.
  26. Kim GG. Predictors of medication adherence in ischemic stroke survivors [master's thesis]. Gwangju: Chonnam National University;2017. p. 1-73.
  27. Sohng KY. The effects of a self-management course on self-efficacy, fatigue, coping skills and self-care activities in patients with systemic lupus erythematosus. Journal of Muscle and Joint Health. 2001;8(2):346-356.
  28. Sohng KY, Paik SI, Cho OH. An analysis of health counselling by the internet in one lupus center. The Journal of Rheumatology Health. 2004;11(1):42-49.