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Published on: November 21, 2013
Path analysis of medication adherence in schizophrenia patients based on the extended theory of planned behavior: A
Xuping Li1, Shuiyuan Xiao2, Yajun Sun3
1Department of Henan Provincial Engineering and Technology Research Centre for Pan-Vascular Disease Prevention and Treatment, Henan Provincial People's Hospital, Zhengzhou, Henan 450003, China; Xiangya School of Public Health, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha City, Hunan Province 410006, China.
Background:
Medication adherence is a significant challenge among community-dwelling patients with schizophrenia. Understanding the influencing factors through the lens of behavioral theory can provide valuable guidance for designing effective interventions to improve medication adherence.
Objectives:
This study aimed to identify the factors associated with medication adherence and the underlying mechanisms, based on the extended Theory of Planned Behavior (TPB), among community-dwelling patients with schizophrenia in China.
Methods:
Medication adherence was measured using the seven-day recall method. Medication attitudes were assessed using the Drug Attitude Inventory-10-Item Version, perceived behavioral control was measured with the Self-Efficacy for Appropriate Medication Use Scale, and subjective norms, intention, and supervision were evaluated using self-developed items. Path analysis was conducted to test the hypotheses based on the extended TPB.
Results:
A total of 468 community-dwelling patients with schizophrenia were surveyed, and 81.20 % of them demonstrated adherent. Intention (standardized effect: 0.897) and supervision (standardized effect: 0.084) were directly associated with medication adherence. Attitude (standardized effect: 0.268, computed as 0.299 × 0.897), subjective norms (standardized effect: 0.283, computed as 0.316 × 0.897), and perceived behavioral control (standardized effect: 0.187, computed as 0.208 × 0.897) were indirectly associated with medication adherence through intention.
Conclusion:
The extended TPB is a suitable model for predicting medication adherence among community-dwelling patients with schizophrenia in China. It provides a robust framework for designing interventions targeting attitude, subjective norms, perceived behavioral control, and supervision to enhance medication adherence.
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