Investigating psychosocial factors and medication adherence among Malaysians with Coronary Heart Disease using mixed methods
<p>Coronary heart disease (CHD) is the leading cause of death in Malaysia, however,</p><p>adherence to medications remains the main issue in achieving optimal treatment</p><p>outcomes. This study was conducted to explore the psych...
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| Format: | thesis |
| Language: | eng |
| Published: |
2023
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| Subjects: | |
| Online Access: | https://ir.upsi.edu.my/detailsg.php?det=10061 |
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| Summary: | <p>Coronary heart disease (CHD) is the leading cause of death in Malaysia, however,</p><p>adherence to medications remains the main issue in achieving optimal treatment</p><p>outcomes. This study was conducted to explore the psychosocial relationships model</p><p>on medication adherence among patients with CHD in Malaysia. The study involved</p><p>the sequential mixed method design; Firstly, it explores the psychosocial factors</p><p>associated with medication adherence through a qualitative interview on the CHD</p><p>patients treatment experiences (N=22, 88% males) as well as their family caregivers</p><p>(N=15). Secondly, questionnaires based on the qualitative findings were developed</p><p>and validated; and finally, the relationships between the psychosocial factors with</p><p>medication adherence among the CHD patients (N=235, 73.6% males) were</p><p>determined. Qualitative findings revealed five factors such as psychosocial beliefs,</p><p>doctor-patient relationship, seeking information behaviour, social support needs, and</p><p>lifestyle changes. Following the qualitative findings, two questionnaires were</p><p>developed and validated which were the CHD-specific modern medication use</p><p>questionnaire (CHD-MMUQ) and the CHD-specific complementary alternative</p><p>medication use questionnaire (CHD-CAMQ). Finally, the multivariate logistic</p><p>regression analysis was conducted and suggests psychosocial factors such as low</p><p>concern-specific beliefs on medications, gender, ethnicity, diet control, and</p><p>performing spiritual practices were statistically significant to predict adherence to</p><p>medication (2 = 61.6, df = 8, N = 235, P< 0.001). The diagnostic test suggested that</p><p>the Nagelkerke pseudo-R-square of the coefficient of determination indicated that</p><p>approximately 33% of the factors in CHD patients were related to medication</p><p>adherence, the model fits well with our data. Assessment of the possible moderating</p><p>influence of medication adherence suggested that CHD patients who controlled diet</p><p>based on ethnicity differences (such as Indian ethics) were associated with significant</p><p>medication adherence, but they were poorly associated with medication adherence if</p><p>an individual was not controlling their diets. Overall, the final results suggested that</p><p>besides the patients treatment psychosocial beliefs, differences based on ethnic</p><p>practices such as diet control are important factors to be considered for better</p><p>medication adherence outcomes.</p> |
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