Browsing by Subject "Treatment adherence"

Now showing 1 - 3 of 3

Illness identity, experience, and perceptions as longitudinal predictors of adherence behaviors and health outcomes in adolescent Cystic Fibrosis
(2021-05-07) Dell, Jordan Rebecca; Rodriguez, Erin M.
People with Cystic Fibrosis (CF) experience considerable symptom and treatment burden on a daily basis. Airway Clearance Therapy (ACT) is one of the most time-consuming treatments and has low rates of adherence. Adherence behaviors are important to address in adolescence, as patients begin to take over responsibility from parents. However, adolescents with CF experience unique barriers to treatment adherence. Their symptoms and treatments can disrupt developmentally-appropriate pursuits like peer relationships and affect identity development. Illness identity describes distinct ways in which chronic illness can be integrated into a patient’s identity, with varying effects on mental health and treatment adherence. Patients’ experience of CF also alters their treatment adherence by affecting beliefs about the necessity and efficacy of their treatments. As such, improving treatment adherence may require considering not only the adolescents’ illness- and treatment-related beliefs, but also the experiences that have informed those beliefs. This study of 120 adolescents with CF recruited from a Central Texas medical center uses regression to determine whether past illness-related health, represented by average pulmonary function, predicts ACT adherence, and whether illness identity and treatment beliefs (Beliefs) mediate the relationship. The study also uses regression to assess whether ACT adherence mediates the relationship between past Beliefs and future pulmonary function. This study would allow clinicians to identify adolescents with uncontrolled illness-related health as at higher risk for developing future maladaptive Beliefs that could affect treatment adherence. It would also provide guidance on targeted interventions for adolescents with chronically poor treatment adherence that take their unique developmental stage into account.
Navigating two alliances with evidence-based practices : relating therapist competence and adherence to youth and caregiver therapeutic alliances
(2018-08-14) Woo, Rebecca Yao Hay; Bearman, Sarah Kate
Despite extensive research on specific treatments and relationship factors in child and adolescent psychotherapy, comparatively little research has addressed in-session process variables concerning how a treatment is delivered. This study examines treatment integrity (therapist adherence and competence) in the delivery of evidence-based practice (EBP) elements and the two therapeutic alliances in youth psychotherapy: the youth-therapist alliance and the caregiver-therapist alliance. Data come from an initial test of a modular, trans-diagnostic therapy protocol of EBP elements with 14 therapists seeing 24 clients and were analyzed using Hierarchical Linear Modeling (HLM). Therapist adherence, competence, and alliance were all measured observationally. In this sample, therapist adherence contributed a small, statistically trending effect on child alliance (d [subscript wt] = 0.008, p = 0.055), while therapist competence did not predict child alliance. Therapist adherence exhibited a small, statistically significant effect on parent alliance (d [subscript wt] = 0.007, p = 0.023). Therapist competence exhibited a large, statistically trending effect on parent alliance (d [subscript wt] = 0.675, p = 0.059). Results suggest that EBP does not harm the therapeutic alliance and may support a stronger alliance with caregivers. Future research should use larger samples to explore how these constructs interact with therapist, youth, and caregiver characteristics to produce outcomes.
Testing the proposed benefits of integrated care : referral compliance, client satisfaction, and treatment adherence
(2016-08) Irvin, Stuart Alan; Drum, David J.; Rude, Stephanie S
Over the past two decades, in an effort to narrow the gap between the fields of medicine and mental health, researchers have increasingly studied models of health care featuring varying degrees of collaboration between the two disciplines. Throughout the literature, models featuring higher degrees of collaboration between primary care providers (PCPs) and mental health providers (MHPs) are hypothesized as having a number of benefits (e.g., higher mental health referral compliance rates, higher client satisfaction, increased treatment adherence, etc.) over models that feature little-to-no collaboration between said providers. This paper encourages future research to put that notion to the test by pitting two models of health care – an ‘integrated care’ model (featuring high collaboration), and a ‘traditional care’ model (featuring low collaboration) – directly against one another. After reviewing some of the current problems with our nation’s healthcare system, the history behind the biopsychosocial movement, and the literature on various models of collaborative care, the author outlines a proposal for how future experimental studies could be developed focusing on three specific outcomes: referral compliance, client satisfaction, and treatment adherence. Research questions, hypotheses, and implications for the health care marketplace are discussed in detail.