Is Adherence Theory for Patients With Chronic Disease Robust?: A Critical Evaluation in Patients After Percutaneous Coronary Intervention.
Outi Kähkönen, Jani Rannanpää
PMID 40540735WHAT IT FOUND
Adherence theory held up over 6 years for the whole group but failed for women.
Motivation predicted adherence for men long-term, while informational support linked to positive care results for women. Gender-specific counseling is needed, not a one-size-fits-all approach.
Key findings
01The adherence model was statistically similar across the 6-year period for the whole group, but significant gender differences appeared in both baseline and follow-up analyses.
02In the long-term follow-up, motivation was associated with adherence only for men, whereas no factors in the female model explained adherence to treatment.
03Informational support was associated with positive results of care for women, while for men it linked indirectly to a sense of normality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Self-reported data may be biased by social desirability, where patients report what they think nurses want to hear. The response rate at the 6-year follow-up was low (40.1%), and those who remained may have been more adherent than those who dropped out. Recruitment occurred at hospital discharge, potentially missing patients who were discharged quickly or had complex issues. The study analyzed data at the group level, which may obscure individual patient experiences.
The easy way to misread this
Do not assume that motivational interviewing works equally well for all patients after PCI. The study found that motivation predicted adherence for men at 6 years but not for women, suggesting that a single adherence theory applied without gender adjustment may fail to support female patients effectively.