A Study of the Factors Related to Medication Adherence and Infection Prevention Behaviors among Renal Transplant Recipients Based on the Health Belief Model
Date Issued
2011
Date
2011
Author(s)
Kung, Pen-Chen
Abstract
This study employs the four basic concepts of the Health Belief Model to investigate the factors influencing the medication adherence and infection prevention behaviors of kidney transplant recipients. Using purposive sampling, this cross-sectional study distributed questionnaires at a medical center in Taipei to patients that had received kidney transplants more than six months previously. A total of 122 valid questionnaires were retrieved. A structural questionnaire was drawn up and employed to collect data in three areas: personal information, health beliefs regarding transplant rejection and infection, and medication adherence and infection prevention actions. The obtained data was analyzed using descriptive statistics, an independent t-test, one-way ANOVA, Pearson’s correlation, and multiple regression. The results of the study are as follows:
1. Health beliefs involving medication adherence and transplant rejection
The average score of the responses from study subjects on correct medication adherence was 4.52. Among the items in this construct, taking the correct dosage of immunosuppressive drugs, scored the highest with an average of 4.91; taking medicine on time, however, was an item implemented less well. The relationship between medication adherence of the study subjects and time elapsed since transplant showed a negative correlation. In regards to factors influencing health beliefs in transplant rejection, patients that had received dialysis treatment or had encountered rejection perceived susceptibility to rejection more strongly. Transplant recipients who had undergone transplants in Taiwan, had suffered more drug-induced symptoms, or had contracted severe to extremely severe infections in the past encountered more barriers in observance of medication adherence. The number of instances of time elapsed since transplant, drug-induced symptoms, perceived susceptibility to rejection, and perceived benefits of medication adherence were the major factors influencing medication adherence.
2. Health beliefs and prevention behavior involving infection
The average score of the overall responses from the study subjects on infection prevention actions was 4.23. Subjects paid the most attention to oral care and hygiene; remembering to wear surgical masks in public was a measure implemented less well. “Forgetting” was the primary reason that prevented transplant recipients from effective implementation of infection prevention measures. Female patients were better at infection prevention than male patients. Transplant recipients showing a higher degree of compliance with water restrictions during dialysis in the past also exhibited better compliance with infection prevention. In regards to factors influencing health beliefs in infection, subjects that perceived more barriers to infection prevention found it more difficult to implement; older subjects and subjects with a shorter dialysis treatment history perceived less susceptibility to infection, and older patients also possessed weaker perceptions of the severity of infection. Unemployed subjects perceived the severity of infection more strongly than those that worked part-time, who further perceived the severity of infection more strongly than retired subjects. Subjects that had a full-time job also perceived the severity of infection more strongly than retired subjects. Subjects that had received their transplants in Taiwan encountered more barriers to infection prevention. Perceived barriers of infection prevention and water restrictions in dialysis treatments in the past were the primary factors influencing actions to prevent infection.
Conclusion: The medication adherence and infection prevention of renal transplant recipients were influenced by their health beliefs. Transplant recipients who received their transplants for a longer period of time, had more drug-induced symptoms, perceived less susceptibility to rejection, or perceived less benefits of medication adherence exhibited relatively poor medication adherence. Transplant recipients who perceived more barriers to infection prevention or exhibited a lower degree of compliance with water restrictions in dialysis treatments in the past were less active in preventing infection.
Subjects
kidney transplant
medication adherence
infection prevention
health beliefs
Type
thesis
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