Adherence determinants in cystic fibrosis: Cluster analysis of parental psychosocial, religious, and/or spiritual factors

Daniel H. Grossoehme, Rhonda D. Szczesniak, Lacrecia L. Britton, Christopher M. Siracusa, Alexandra Quittner, Barbara A. Chini, Sophia M. Dimitriou, Michael Seid

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Rationale: Cystic fibrosis is a progressive disease requiring a complex, time-consuming treatment regimen. Nonadherence may contribute to an acceleration of the disease process. Spirituality influences some parental healthcare behaviors and medical decision-making. Objectives: We hypothesized that parents of children with cystic fibrosis, when classified into groups based on adherence rates, would share certain psychosocial and religious and/or spiritual variables distinguishing them from other adherence groups. Methods: We conducted a multisite, prospective, observational study focused on parents of children younger than 13 years old at two cystic fibrosis center sites (Site 1, n = 83; Site 2, n = 59). Religious and/or spiritual constructs, depression, and marital adjustment were measured by using previously validated questionnaires. Determinants of adherence included parental attitude toward treatment, perceived behavioral norms, motivation, and self-efficacy. Adherence patterns were measured with the Daily Phone Diary, a validated instrument used to collect adherence data. Cluster analysis identified discrete adherence patterns, including parents' completion of more treatments than prescribed. Measurements and Main Results: For airway clearance therapy, four adherence groups were identified: median adherence rates of 23%, 52%, 77%, and 120%. These four groups differed significantly for parental depression, sanctification of their child's body, and self-efficacy. Three adherence groups were identified for nebulized medications: median adherence rates of 35%, 82%, and 130%. These three groups differed significantly for sanctification of their child's body and self-efficacy. Conclusions: Our results indicated that parents in each group shared psychosocial and religious and/or spiritual factors that differentiated them. Therefore, conversations about adherence likely should be tailored to baseline adherence patterns. Development of efficacious religious and/or spiritual interventions that promote adherence by caregivers of children with cystic fibrosis may be useful.

Original languageEnglish (US)
Pages (from-to)838-846
Number of pages9
JournalAnnals of the American Thoracic Society
Volume12
Issue number6
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

Fingerprint

Cystic Fibrosis
Cluster Analysis
Self Efficacy
Parents
Depression
Social Adjustment
Spirituality
Medication Adherence
Therapeutics
Caregivers
Observational Studies
Motivation
Prospective Studies
Delivery of Health Care

Keywords

  • Cystic fibrosis
  • Parents
  • Psychosocial
  • Spirituality
  • Treatment adherence

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Grossoehme, D. H., Szczesniak, R. D., Britton, L. L., Siracusa, C. M., Quittner, A., Chini, B. A., ... Seid, M. (2015). Adherence determinants in cystic fibrosis: Cluster analysis of parental psychosocial, religious, and/or spiritual factors. Annals of the American Thoracic Society, 12(6), 838-846. https://doi.org/10.1513/AnnalsATS.201408-379OC

Adherence determinants in cystic fibrosis : Cluster analysis of parental psychosocial, religious, and/or spiritual factors. / Grossoehme, Daniel H.; Szczesniak, Rhonda D.; Britton, Lacrecia L.; Siracusa, Christopher M.; Quittner, Alexandra; Chini, Barbara A.; Dimitriou, Sophia M.; Seid, Michael.

In: Annals of the American Thoracic Society, Vol. 12, No. 6, 01.06.2015, p. 838-846.

Research output: Contribution to journalArticle

Grossoehme, DH, Szczesniak, RD, Britton, LL, Siracusa, CM, Quittner, A, Chini, BA, Dimitriou, SM & Seid, M 2015, 'Adherence determinants in cystic fibrosis: Cluster analysis of parental psychosocial, religious, and/or spiritual factors', Annals of the American Thoracic Society, vol. 12, no. 6, pp. 838-846. https://doi.org/10.1513/AnnalsATS.201408-379OC
Grossoehme, Daniel H. ; Szczesniak, Rhonda D. ; Britton, Lacrecia L. ; Siracusa, Christopher M. ; Quittner, Alexandra ; Chini, Barbara A. ; Dimitriou, Sophia M. ; Seid, Michael. / Adherence determinants in cystic fibrosis : Cluster analysis of parental psychosocial, religious, and/or spiritual factors. In: Annals of the American Thoracic Society. 2015 ; Vol. 12, No. 6. pp. 838-846.
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abstract = "Rationale: Cystic fibrosis is a progressive disease requiring a complex, time-consuming treatment regimen. Nonadherence may contribute to an acceleration of the disease process. Spirituality influences some parental healthcare behaviors and medical decision-making. Objectives: We hypothesized that parents of children with cystic fibrosis, when classified into groups based on adherence rates, would share certain psychosocial and religious and/or spiritual variables distinguishing them from other adherence groups. Methods: We conducted a multisite, prospective, observational study focused on parents of children younger than 13 years old at two cystic fibrosis center sites (Site 1, n = 83; Site 2, n = 59). Religious and/or spiritual constructs, depression, and marital adjustment were measured by using previously validated questionnaires. Determinants of adherence included parental attitude toward treatment, perceived behavioral norms, motivation, and self-efficacy. Adherence patterns were measured with the Daily Phone Diary, a validated instrument used to collect adherence data. Cluster analysis identified discrete adherence patterns, including parents' completion of more treatments than prescribed. Measurements and Main Results: For airway clearance therapy, four adherence groups were identified: median adherence rates of 23{\%}, 52{\%}, 77{\%}, and 120{\%}. These four groups differed significantly for parental depression, sanctification of their child's body, and self-efficacy. Three adherence groups were identified for nebulized medications: median adherence rates of 35{\%}, 82{\%}, and 130{\%}. These three groups differed significantly for sanctification of their child's body and self-efficacy. Conclusions: Our results indicated that parents in each group shared psychosocial and religious and/or spiritual factors that differentiated them. Therefore, conversations about adherence likely should be tailored to baseline adherence patterns. Development of efficacious religious and/or spiritual interventions that promote adherence by caregivers of children with cystic fibrosis may be useful.",
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