Compliance in cystic fibrosis: An examination of infection control guidelines

Abstract

The goal of this research was to begin the process of evaluating acceptability of infection control (IC) recommendations to CF patients and their families, determine whether compliance with IC guidelines differs from compliance with traditional CF medical treatment with respect to the variables predictive of compliance, and assess which patients are most likely to comply with IC recommendations. Participants were recruited during routine outpatient visits at a regional CF center located in a pediatric hospital. The sample included 44 child and adolescent patients, aged 9-18 years and their guardian, and 27 adult patients. All patients completed questionnaires and interviews. Results of this preliminary study suggest that many individuals with CF are unaware of or unconcerned with the risks involved in infection transmission via social contact with other CF patients. Further, most participants reported that they could benefit from friendships with other CF patients. Health belief variables were found to be predictive of compliance with both IC guidelines and traditional medical treatments in the adult and parent sample, but not in the child sample. Possible explanations for study findings are discussed and recommendations for future research on IC compliance are highlighted.

Adherence to infection prevention and control guidelines: A vignette-based study of decision-making and risk-taking in young adults with cystic fibrosis

“…In contrast to existing data 10,12 , participants were C:\Users\liblbo\Downloads\Grace Bowmer -Adherence to Infection Prevention and Control Guidelines -JCF.docx largely unwilling to engage in activities that posed significantly increased risk; however, most opted to engage in behaviours that posed some risk (e.g., >50% opted to use a Jacuzzi or hot tub). Such decisions may partially reflect 'optimism-bias' rather than lack of knowledge per se 10 , where individuals perceived that their chances of experiencing adverse effects were smaller than others' 14 . Participants broadly demonstrated accurate risk-appraisal and most decisions were concurrent with their judgement, though as decisions were indicated before rating perceived risk it is possible that the decisions influenced the subsequent rating rather than vice versa.…”

“…Whilst non-adherence to CF treatments is well-reported and linked to negative health outcomes [5][6][7][8][9] , adherence to IPC recommendations is less well-understood. Patient rates of avoiding contact with other people with CF are reported to be low (21%-27%), particularly in young adults 10,11 . Similarly, in a sample of UK adults (n=94), 35% reported mixing with others whilst in hospital, despite almost 64% having been informed of cross-infection risk 12 .…”

“…Patients may doubt the potential infection risk and prioritise the benefits over the costs of meeting someone with CF 10,12 .…”

Phase II study of transdermal estradiol in androgen‐independent prostate carcinoma

“…National guidelines to avoid close contact have only been the standard of care for several years, so older patients may have been socializing with other patients for a number of years and may have greater difficulty accepting recent infection control recommendations and changing their social network. Masterson et al12 found a similar lack of infection control knowledge; among 71 CF patients ≥9 years of age, 21% reported they had contact with CF friends, 40% reported they did not feel they could get ill from contact with another person with CF, and 70% perceived social benefits from having a friend with CF.…”

Impact of age and gender on adherence to infection control guidelines and medical regimens in cystic fibrosis

“…Also, because CF is a genetic disease, many individuals with CF have relatives with the disease, making it difficult to avoid physical contact. Researchers have cited the negative social consequences associated with IC guidelines and the alteration of previous clinical practices (i.e., CF patients were previously permitted to interact during inpatient, outpatient, and social events and develop support systems with other CF patients) as potential barriers to successful implementation of IC guidelines 11, 12…”