Hypothetical model of perceived adherence to treatment among patients with coronary heart disease after a percutaneous coronary intervention.
Outi Kähkönen, Päivi Kankkunen, Terhi Saaranen and 2 others
PMID 31871708WHAT IT FOUND
Among 418 patients 4 months after PCI, motivation, physician support and family support were linked to self-reported adherence.
The model partly fit, but cannot show these factors cause better adherence.
Key findings
01Respondents reported high levels of adherence to treatment (mean 89.9, median 90.0, range 30.0 to 100.0, SD 11.2).
02In the eventual model, motivation had the strongest association with perceived adherence, and perceived adherence was directly associated with support from physicians and next of kin.
03The initial model was rejected because several hypothesized relationships did not fit the data; the eventual model explained 30% of variance in factors associated with adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was a cross-sectional survey, so it cannot show which factor caused adherence. Adherence, social support and perceived health were self-reported, and patients may have given answers they thought were favourable. The adherence visual analogue scale was developed for this study, and its reliability and validity had not been tested previously. The questionnaire had 56 Likert items, two visual analogue scales and 18 background questions, which may have burdened patients and affected accuracy. The original model was rejected because several hypothesized relationships did not fit the data, and only part of the model was confirmed. Only Finnish-speaking patients aged 18 to 75 without memory disorder were included, so results may not apply to others.
Declared interests
No conflict of interest was declared. The study was supported by an educational grant from the Finnish Foundation of Cardiovascular Disease and Finnish Nursing Associations.
The easy way to misread this
Do not read motivation, physician support or family support as proven causes of better adherence. This was a cross-sectional survey of self-reported data, and the model only showed associations.