Abstract：
Although familial hypercholesterolemia (FH) can be effectively managed using cholesterol-lowering medication, patients often fall short of complete treatment adherence. Identifying the psychological factors associated with self-regulation of FH medication is important to inform interventions to maximize adherence. The aim of the present study was to test an integrated psychological model in predicting FH patients\' intentions to take medication.
FH patients attending clinics in seven countries were invited to participate in a cross-sectional survey study. Consenting patients (N = 551) completed self-report measures of generalized beliefs about medication overuse and harms, beliefs in treatment effectiveness, specific beliefs about taking medication (attitudes, subjective norms, perceived behavioral control), and intentions to take medication. Participants also completed measures of demographic variables (age, gender, education level, income, cardiovascular disease status). Data were analysed using path analysis controlling for country and demographic variables.
Attitudes (β = .331, p<0.001), subjective norms (β = .121, p=0.009), and beliefs about medication overuse (β = -.160, p<0.001) were significant predictors of intentions to take medication. Treatment beliefs predicted intentions indirectly (β = .088, p<0.001) through attitudes and subjective norms. There was also an indirect effect of beliefs about medication overuse on intentions (β = -.045, p=0.056), but the effect was small compared with the direct effect.
The findings indicate the importance among FH patients of specific beliefs about taking medication and generalized beliefs about medication overuse and treatment in predicting medication intentions. When managing patients, clinicians should emphasize the efficacy of taking cholesterol-lowering drugs and the importance of treatment outcomes, and allay concerns about medication overuse.
FH patients attending clinics in seven countries were invited to participate in a cross-sectional survey study. Consenting patients (N = 551) completed self-report measures of generalized beliefs about medication overuse and harms, beliefs in treatment effectiveness, specific beliefs about taking medication (attitudes, subjective norms, perceived behavioral control), and intentions to take medication. Participants also completed measures of demographic variables (age, gender, education level, income, cardiovascular disease status). Data were analysed using path analysis controlling for country and demographic variables.
Attitudes (β = .331, p<0.001), subjective norms (β = .121, p=0.009), and beliefs about medication overuse (β = -.160, p<0.001) were significant predictors of intentions to take medication. Treatment beliefs predicted intentions indirectly (β = .088, p<0.001) through attitudes and subjective norms. There was also an indirect effect of beliefs about medication overuse on intentions (β = -.045, p=0.056), but the effect was small compared with the direct effect.
The findings indicate the importance among FH patients of specific beliefs about taking medication and generalized beliefs about medication overuse and treatment in predicting medication intentions. When managing patients, clinicians should emphasize the efficacy of taking cholesterol-lowering drugs and the importance of treatment outcomes, and allay concerns about medication overuse.
摘要：
尽管家族性高胆固醇血症（FH）可以使用降胆固醇药物进行有效管理，患者往往不能完全坚持治疗。确定与FH药物的自我调节相关的心理因素对于告知干预措施以最大程度地依从性很重要。本研究的目的是测试预测FH患者服药意向的综合心理模型。
在7个国家的诊所就诊的FH患者被邀请参加横断面调查研究。同意的患者（N=551）完成了关于药物过度使用和危害的普遍信念的自我报告措施，对治疗有效性的信念，关于服药的具体信念(态度，主观规范，感知的行为控制)，和服用药物的意图。参与者还完成了人口统计学变量的测量(年龄，性别,教育水平,收入,心血管疾病状态)。使用路径分析控制国家和人口变量来分析数据。
态度（β=.331，p<0.001），主观规范(β=0.121，p=0.009)，和对药物过度使用的信念（β=-.160，p<0.001）是服用药物意向的重要预测因素。治疗信念通过态度和主观规范间接预测意向（β=0.088，p<0.001）。关于药物过度使用的信念对意图也有间接影响(β=-.045，p=0.056)，但与直接效应相比，效果较小。
研究结果表明，在FH患者中，关于服用药物的特定信念和关于药物过度使用和治疗的普遍信念在预测药物意图方面的重要性。在管理患者时，临床医生应强调服用降胆固醇药物的疗效和治疗结果的重要性，并减轻对药物过度使用的担忧。
在7个国家的诊所就诊的FH患者被邀请参加横断面调查研究。同意的患者（N=551）完成了关于药物过度使用和危害的普遍信念的自我报告措施，对治疗有效性的信念，关于服药的具体信念(态度，主观规范，感知的行为控制)，和服用药物的意图。参与者还完成了人口统计学变量的测量(年龄，性别,教育水平,收入,心血管疾病状态)。使用路径分析控制国家和人口变量来分析数据。
态度（β=.331，p<0.001），主观规范(β=0.121，p=0.009)，和对药物过度使用的信念（β=-.160，p<0.001）是服用药物意向的重要预测因素。治疗信念通过态度和主观规范间接预测意向（β=0.088，p<0.001）。关于药物过度使用的信念对意图也有间接影响(β=-.045，p=0.056)，但与直接效应相比，效果较小。
研究结果表明，在FH患者中，关于服用药物的特定信念和关于药物过度使用和治疗的普遍信念在预测药物意图方面的重要性。在管理患者时，临床医生应强调服用降胆固醇药物的疗效和治疗结果的重要性，并减轻对药物过度使用的担忧。
