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Pediatric adherence as a multidimensional and dynamic construct, involving a triadic partnership
Mirella De Civita1, Patricia L Dobkin
1McGill University Health Center, Division of Clinical Epidemiology, Montréal, Québec, Canada. mirella@epimgh.mcgill.ca
Journal of Pediatric Psychology
|May 8, 2004
Summary
This study proposes a new model for pediatric adherence, viewing it as multidimensional, dynamic, and a triadic partnership between child, caregiver, and medical team. Further research is needed to validate this comprehensive adherence framework.
Area of Science:
- Pediatric adherence research
- Health psychology
- Behavioral medicine
Background:
- Pediatric adherence research has advanced in identifying correlates and interventions.
- Current work lacks a unifying framework for conceptualizing and measuring adherence.
- Adherence is crucial for effective pediatric treatment outcomes.
Purpose of the Study:
- To present a novel conceptualization of pediatric adherence.
- To integrate research supporting adherence as multidimensional, dynamic, and a triadic partnership.
- To provide a framework for measuring and understanding pediatric adherence.
Main Methods:
- Literature review of Medline, PsychLit, and reference lists.
- Synthesis of existing research findings on pediatric adherence.
- Development of a conceptual model for adherence.
Main Results:
- A model is proposed viewing adherence as multidimensional, encompassing complex treatment components.
- Adherence is conceptualized as a triadic partnership involving child, caregiver, and medical team interactions.
- The model incorporates dynamic aspects, including developmental capacity, context, and disease course.
Conclusions:
- The proposed adherence model requires further validation, refinement, and extension.
- Recommendations are provided for assessing the multidimensional, triadic, and dynamic aspects of adherence.
- A group-based, longitudinal methodology is suggested for future research.