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 language | English (US) |
|---|---|
| Pages (from-to) | 838-846 |
| Number of pages | 9 |
| Journal | Annals of the American Thoracic Society |
| Volume | 12 |
| Issue number | 6 |
| DOIs | |
| State | Published - Jun 1 2015 |
| Externally published | Yes |
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Keywords
- Cystic fibrosis
- Parents
- Psychosocial
- Spirituality
- Treatment adherence
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
Cite this
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 journal › Article
}
TY - JOUR
T1 - Adherence determinants in cystic fibrosis
T2 - Cluster analysis of parental psychosocial, religious, and/or spiritual factors
AU - Grossoehme, Daniel H.
AU - Szczesniak, Rhonda D.
AU - Britton, Lacrecia L.
AU - Siracusa, Christopher M.
AU - Quittner, Alexandra
AU - Chini, Barbara A.
AU - Dimitriou, Sophia M.
AU - Seid, Michael
PY - 2015/6/1
Y1 - 2015/6/1
N2 - 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.
AB - 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.
KW - Cystic fibrosis
KW - Parents
KW - Psychosocial
KW - Spirituality
KW - Treatment adherence
UR - http://www.scopus.com/inward/record.url?scp=84942254062&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84942254062&partnerID=8YFLogxK
U2 - 10.1513/AnnalsATS.201408-379OC
DO - 10.1513/AnnalsATS.201408-379OC
M3 - Article
C2 - 25803407
AN - SCOPUS:84942254062
VL - 12
SP - 838
EP - 846
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
SN - 2325-6621
IS - 6
ER -