陆军军医大学学报 (Jun 2022)
Moderated-mediating effect of influencing factors and coping styles of treatment adherence in pulmonary tuberculosis patients based on knowledge-attitude-practice model
Abstract
Objective To explore the influencing factors of patient adherence behavior to tuberculosis treatment based on knowledge-attitude-practice (KAP) model and investigate the moderating effect of coping styles on the behaviors. Methods A total of 231 pulmonary tuberculosis patients were recruited from the Tuberculosis Clinic of Chongqing Public Health Medical Center from April 8 to June 9, 2021. There were 133 males and 98 females, with an average age of 26.97±8.57 years. A cross-sectional survey was conducted using a Web-based questionnaire to collect their demographic data, knowledge, attitudes and self-reported practice behaviors related to treatment compliance, and coping styles (confrontation, avoidance and acceptance-resignation). Results ① Adherence knowledge and attitudes showed positive predictive effect on adherence behavior (β=3.014, β=0.505, P < 0.01); ② Adherence knowledge had positive predictive effect on adherence attitudes (β=2.587, P < 0.01); ③ Adherence attitudes still showed significant predictive effect on adherence behavior even when acceptance-resignation at lower level(x-1s)and average level(x)(ρ=0.483, 95%CI: 0.293~0.674, P < 0.01; ρ=0.271, 95%CI: 0.170~0.373, P < 0.01), but the effect was not significant when acceptance-resignation at high level(x±1s)(ρ=0.059, 95%CI: -0.071~0.189); ④ The interaction between avoidance and adherence knowledge showed negative predictive effect on adherence attitudes (β=-0.144, P < 0.05), while the interaction between confrontation and adherence knowledge was positive predictor for adherence attitudes (β=0.066, P < 0.05). Conclusion Improvement of adherence knowledge and attitudes contribute to adherence behavior. A decreased acceptance-resignation level can help the pulmonary tuberculosis patients enhance adherence attitude and promote their adherence behavior.
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