Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention

Abstract

Because a healthy lifestyle predicted factors known to explain adherence, these issues should be emphasised particularly for female patients not in a close personal relationship, with low education and a shorter coronary heart disease duration with previous coronary intervention.

Hypothetical model of perceived adherence to treatment among patients with coronary heart disease after a percutaneous coronary intervention

“…The aim of the present study was to test whether empirical data would fit the proposed hypothetical model of perceived adherence to treatment (Figure ) based on four sub‐studies: testing the theory of adherence to treatment of chronically ill patient among patients (Kähkönen et al, ), description and exploration of the predictors of adherence to treatment (Kähkönen et al, ), perceived health (Kähkönen, Saaranen, Lamidi, Miettinen, & Kankkunen, ), received social support (Kähkönen, Kankkunen, Miettinen, Lamidi, & Saaranen, ) and associated factors among patients with CHD after PCI. The hypothetical model of perceived adherence to treatment was created based on the statistically significant findings in these sub‐studies.…”

“…The data were collected using a postal questionnaire 4 months after PCI between January and December 2013 via the following four instruments: The adherence of patient with chronic disease (ACDI) instrument, which is based on a theoretical model of chronically ill patients developed and tested originally by Kyngäs (). The ACDI contained 37 items of adherence to treatment, which were rated on a 5‐point Likert scale (‘definitely disagree’ to ‘definitely agree’). The adherence visual analogue scale (A‐VAS) instrument, which records the respondents’ self‐rated adherence to treatment from the best imaginable adherence to treatment (100) to the worst imaginable adherence to treatment (0) developed by Kähkönen et al (). The social support for people with coronary heart disease (SSCHD) instrument, developed by Kähkönen et al () for the present study and based on the Cohen and Wills's (1985) theory of social support. The SSCHD included 14 items related to receiving social support: informational, emotional and functional support, which were rated on a 5‐point Likert scale (‘definitely disagree’ to ‘definitely agree’). The EuroQoL five‐dimensional scale (EQ‐5D‐5L) regarding the severity of problems on the perceived health dimensions were rated on a 5‐point Likert scale (1 = no problems, 2 = mild problems, 3 = some problems, 4 = moderate problems, 5 = extreme problems). The EuroQoL visual analogue scale (EQ‐VAS) ranking respondents’ perceived health with endpoints labelled the best imaginable health (100) and the worst imaginable health state (0). …”

“…Adherence to treatment consists of adherence to medication and a healthy lifestyle, including a healthy diet, physical activity, non‐smoking and moderate alcohol consumption. Explanatory factors associated with adherence to treatment according to Kyngäs's original Theory of Adherence among People with Chronic Disease are responsibility, cooperation, a sense of normality, motivation, the results of care, support from next of kin, support from nurses, support from physicians and a fear of complications (Kähkönen et al, ; Kyngäs, ; Oikarinen et al, ). The Theory of Adherence among People with Chronic Disease as a theoretical framework to evaluate post‐PCI patients’ adherence has been tested.…”

“…The Theory of Adherence among People with Chronic Disease as a theoretical framework to evaluate post‐PCI patients’ adherence has been tested. Cooperation, a sense of normality, motivation, the results of care, support from next of kin, support from physicians and a fear of complications have been shown to explain adherence to treatment among patients with CHD after PCI (Kähkönen et al, ). Post‐PCI patients’ non‐adherence to treatment may be intentional or unintentional.…”

“…Furthermore, a low level of social support is considered a risk factor for CHD in healthy people, as well as a risk factor for worse prognoses and higher mortality among patients diagnosed with CHD (Valtorta et al, ; Xia & Li, ). The dimensions of social support, such as support from next of kin, physicians and nurses, have been proven to be significant factor associated with adherence among chronically ill patients (Kähkönen et al, ; Kyngäs, ). Social support has been defined as a dynamic interpersonal process centred on the reciprocal exchange of information.…”