Health Control Beliefs and Attitude Toward Treatment in Psychiatric and Non-Psychiatric Clinical Samples

Abstract

Although there is accumulating evidence on the potential influencing factors of medication adherence, the knowledge about patients' attitudes and beliefs toward treatment is only partly utilized in adherence-improving strategies. Several internal and external factors determining adherence have been described regarding many chronic somatic diseases but in recent research, insight on psychiatric patients has been exclusively lacking. As a result, there is a scarcity of effective adherence-improving interventions. Identification of any specific differences or similarities between the attitudes toward treatment of psychiatric and non-psychiatric patients would help to support adherent behavior.We recruited 189 participants from four departments of general psychiatry (GEN PSYCH, n = 106), addictology (ADDICT, n = 42) and somatic diseases (NON PSYCH, n = 41). The Patient's Health Belief Questionnaire on Psychiatric Treatment (PHBQPT) was performed to assess the patients' attitude toward drug treatment, perceived health locus of control, and psychological reactance.The most robust difference of the PHBQT scores occurred between the GEN PSYCH and ADDICT subgroups. ADDICT patients scored significantly higher on the internal and external health locus of control and on the Psychological Reactance subscale as well. While GEN PSYCH subjects provided higher scores on the Positive Aspect of Medication compared to ADDICT persons. Interestingly, the only difference between the GEN PSYCH and NON-PSYCH groups was the more pronounced mistrust in physicians in the case of psychiatric patients.Our data suggest that mistrust toward medication does not differ in psychiatric and non-psychiatric samples, while the acceptance of the doctor's competency may be stronger in the non-psychiatric sample. The analysis of these factors provides information which could help us better understand this important issue and to develop more efficient interventions for improving adherence.

Psychiatric Patients’ Perceived Health Control and Reactance: Implications for Medication Adherence

“…The PHBQ-PT has been used in various studies to assess health beliefs and treatment adherence in patients with psychiatric disorders, including depression, bipolar disorder, and schizophrenia. [47][48][49][50][51] Overall, the PHBQ-PT is a useful tool for assessing health beliefs and treatment adherence in patients with psychiatric disorders, and can help healthcare providers tailor their approach to treatment to improve patient outcomes.…”

Psychometric Properties of the Malay Translation of the Medication Adherence Rating Scale

“…It was also noted that individuals with a higher education level tend to be more skeptical about psychotropic medications [ 23 ]. Patients’ perceptions of health locus of control also influenced their view on the effects of medications [ 24 ]. Health locus of control was defined by the degree to which individuals believed that their mental state and body conditions were controlled by internal vs. external factors.…”

Exploring the perceptions of patients with chronic respiratory diseases and their insights into pulmonary rehabilitation in Bangladesh

“…Patients are confronted with the challenge of understanding and managing a complex disease process in their context. Without an understanding of their condition, they are unable to take necessary measures to maintain their health or make informed decisions about their well-being [ 28 , 29 ], which affects their adherence to recommended management strategies [ 29 ]…”

“…We also found that the understanding of the disease process by families and friends can have a significant impact on the patient's acceptance of pulmonary rehabilitation. There is also evidence that acceptance of pulmonary rehabilitation is affected by capability-related factors, such as patients' cognitive abilities, understanding of the disease, and their ability to access the programme [ 29 , 31 ]. We did not formally assess cognition but identified multiple practical barriers that reduced the ability to adhere to a pulmonary rehabilitation regime.…”

“…Patients are confronted with the challenge of understanding and managing a complex disease process in their context. Without an understanding of their condition, they are unable to take necessary measures to maintain their health or make informed decisions about their well-being [28,29], which affects their adherence to recommended management strategies [29] The adoption of pulmonary rehabilitation poses a challenge for patients in Bangladesh, as it is a new intervention that leaves many of their questions unanswered. A systematic review of 48 studies conducted in a range of settings globally, concluded that factors such as context, environment, people's knowledge, and beliefs influenced uptake, attendance, and completion of pulmonary rehabilitation.…”