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Is Adherence Theory for Patients With Chronic Disease Robust?: A Critical Evaluation in Patients After Percutaneous
Outi Kähkönen1, Jani Rannanpää2
1Outi Kähkönen, PhD, Senior Researcher, Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Insights
Understanding patient adherence after percutaneous coronary intervention is key. Adherence Theory factors varied by gender, with motivation impacting men but not women, highlighting the need for tailored nursing interventions.
Area of Science:
- Cardiology and Nursing Science
- Health Outcomes Research
- Behavioral Science
Background:
- Optimal health outcomes post-percutaneous coronary intervention (PCI) depend on patient adherence.
- Understanding adherence strategies is crucial for effective patient management.
- Chronic disease management after PCI requires a focus on long-term adherence.
Purpose of the Study:
- To investigate the associations within Adherence Theory for patients with chronic disease undergoing PCI.
- To examine long-term adherence patterns over a 6-year follow-up period.
- To identify factors influencing adherence in a post-PCI population.
Main Methods:
- A descriptive, exploratory study design utilizing survey data.
- Two-time point data collection in 2013 (n=416) and 2019 (n=167) over 6 years.
- Structural equation modeling applied to assess Adherence Theory constructs and social support questionnaires.
Main Results:
- Adherence Theory demonstrated a robust structure with no significant changes between 2013 and 2019.
- Significant gender differences in adherence factors were observed.
- Motivation directly influenced adherence in men, with indirect links to social support and normality; women's adherence was not significantly influenced by identifiable factors.
Conclusions:
- Nursing theories require critical reassessment for continued relevance in patient care.
- Research-based knowledge is essential for developing person-centered nursing interventions.
- Tailoring interventions based on gender-specific adherence factors is recommended for post-PCI patients.
Background:
A comprehensive understanding of the strategies that promote adherence is important for achieving optimal health outcomes in patients after percutaneous coronary intervention.
Objective:
The aim of this study was to investigate the associations within Adherence Theory for patients with chronic disease after percutaneous coronary intervention during a long-term follow-up.
Design:
A descriptive and exploratory study design was used in this study, with a survey conducted at 2 time points over 6 years.
Methods:
Structural equation modeling was used to evaluate the model with baseline data from 2013 (n = 416) and follow-up data from 2019 (n = 167). The instruments used included the Adherence of Patients with Chronic Diseases and Social Support of People with Coronary Heart Disease questionnaires.
Results:
Adherence Theory for patients with chronic disease showed a robust structure with no significant differences between 2013 and 2019. However, significant gender differences were observed in both years. Motivation was directly associated with adherence in 2013. For men, indirect associations were found between informational support, sense of normality, support from next of kin, and results of care. Adherence for women was not influenced by any identifiable factors in 2019, as observed in 2013. Among men, motivation was directly associated with adherence and indirectly linked to a sense of normality, fear of complications, and support from next of kin.
Conclusions:
The results underscore the importance of critically reassessing nursing theories to ensure their relevance. This research-based knowledge can then be used to develop nursing interventions that promote person-centered care.
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