[Relationships among illness perceptions, medication beliefs and medication adherence in primary angle closure glaucoma patients].

Objective: To investigate the relationships among illness perception, medication beliefs and medication adherence in primary angle closure glaucoma patients. Methods: It was a cross-sectional study. Morisky 8-item Medication Adherence Questionnaire Chinese Revised, the Brief Illness Perceptions Questionnaire, the Specific Section of the Beliefs about Medicine Questionnaire Chinese Revised were administered to 156 primary angle closure glaucoma patients from Tianjin Eye Hospital. Chi-square test was used to analyze the types of glaucoma, gender, prescription complexity, medicine schedule, other disease and course of disease between the group of adherence and non-adherence. Pearson correlation method was used to analyze the correlations among the illness perception, necessity belief, concerns belief and medication adherence. Structural equation model was used to analyze the mediational role of medication belief between illness perception and medication adherence. Results: In the 156 primary angle closure glaucoma patients being investigated, 37 male and 119 female, the average age was (61.3±8.3) years old. The medication adherence of patients was 83 (53.2%) , the medication non-adherence of patients was 73 (46.8%) . It was showed that prescription complexity and medicine schedule were significantly correlated with medicine adherence (χ(2)=13.64, 11.31; P<0.05); gender, other disease and course of disease were not correlated with medication adherence (χ(2)=1.02, 1.73, 6.08; P>0.05). The scores of illness perception were positively correlated with the necessity belief of medication scores, the scores of concerns belief (r=0.18、0.45, P<0.05), and were negatively associated with medication adherence (r=-0.22, P<0.01). The concerns belief of medication scores were negatively correlated with the medication adherence (r=-0.47, P<0.01). Concerns belief mediates the relationship between illness perception and medication adherence wholly (χ(2)/df=1.73, RMSEA=0.069, NNFI=0.98, CFI=0.98, IFI=0.98) . Conclusions: The types of medicines and the number of glaucoma medication used have a significant influence to the medication adherence in the patients with primary angle closure glaucoma. The patients with greater illness perception performed greater non-adherence can be explained by their higher concerns blief. (Chin J Ophthalmol, 2017, 53: 109-114).目的： 探讨影响PACG患者用药依从性的主要因素及其与疾病感知、药物信念的关系。 方法： 横断面研究。采用Morisky用药依从性量表中文修订版、疾病感知问卷简版和药物信念特异性量表中文修订版对天津市眼科医院156例PACG患者进行问卷调查。采用χ(2)检验对依从性好和依从性差两组中的青光眼类型、性别构成、服药种类、有无其他疾病、病程和服药次数进行分析；用皮尔逊相关法对疾病感知、药物必要性信念、担忧信念和用药依从性之间的关系进行相关分析；用结构方程模型对药物信念在疾病感知和用药依从性间的中介作用进行分析。 结果： 156例PACG患者中，男性37例，女性119例；平均年龄为（61.3±8.3）岁。用药依从性好的患者83例（53.2%），依从性差的患者73例（46.8%）。调查分析结果表明，患者的用药种类（χ(2)=13.64，P=0.009）和用药次数（χ(2)=11.31，P=0.010）对用药依从性有影响，差异有统计学意义（P<0.05）；性别（χ(2)=1.02，P=0.311）、有无其他疾病（χ(2)=1.73，P=0.188）和病程（χ(2)=6.08，P=0.108）对用药依从性无明显影响，差异无统计学意义（P>0.05）；Pearson积差相关分析结果表明，PACG患者疾病感知得分与对药物的必要性信念、担忧信念得分呈正相关（r=0.18，0.45，均P<0.05），与用药依从性得分呈负相关（r=-0.22，P<0.01）；担忧信念得分与用药依从性得分呈负相关（r=-0.47，P<0.01）；结构方程模型分析表明，PACG患者对药物的担忧信念完全中介了疾病感知和用药依从性的关系[卡方/自由度（χ(2)/df）=1.73，近似误差均方根（RMSEA）=0.069，非范拟合指数（NNFI）=0.98，相对拟合指数（CFI）=0.98，递增拟合指数（IFI）=0.98]。 结论： PACG患者的用药种类和次数对用药依从性有显著影响。疾病感知水平越高，对药物的担忧信念越高，用药依从性越低。（中华眼科杂志，2017，53：109-114）.