Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2015 Jun;12(6):838-46.
doi: 10.1513/AnnalsATS.201408-379OC.

Adherence Determinants in Cystic Fibrosis: Cluster Analysis of Parental Psychosocial, Religious, and/or Spiritual Factors

Daniel H Grossoehme  1 , Rhonda D Szczesniak  1   2 , LaCrecia L Britton  3 , Christopher M Siracusa  1 , Alexandra L Quittner  4 , Barbara A Chini  1 , Sophia M Dimitriou  1 , Michael Seid  1   5
Affiliations
Observational Study

Adherence Determinants in Cystic Fibrosis: Cluster Analysis of Parental Psychosocial, Religious, and/or Spiritual Factors

Daniel H Grossoehme et al. Ann Am Thorac Soc. 2015 Jun.

Abstract

Rationale: Cystic fibrosis is a progressive disease requiring a complex, time-consuming treatment regimen. Nonadherence may contribute to an acceleration of the disease process. Spirituality influences some parental healthcare behaviors and medical decision-making.

Objectives: We hypothesized that parents of children with cystic fibrosis, when classified into groups based on adherence rates, would share certain psychosocial and religious and/or spiritual variables distinguishing them from other adherence groups.

Methods: We conducted a multisite, prospective, observational study focused on parents of children younger than 13 years old at two cystic fibrosis center sites (Site 1, n= 83; Site 2, n = 59). Religious and/or spiritual constructs, depression, and marital adjustment were measured by using previously validated questionnaires. Determinants of adherence included parental attitude toward treatment, perceived behavioral norms, motivation, and self-efficacy. Adherence patterns were measured with the Daily Phone Diary, a validated instrument used to collect adherence data. Cluster analysis identified discrete adherence patterns, including parents' completion of more treatments than prescribed.

Measurements and main results: For airway clearance therapy, four adherence groups were identified: median adherence rates of 23%, 52%, 77%, and 120%. These four groups differed significantly for parental depression, sanctification of their child's body, and self-efficacy. Three adherence groups were identified for nebulized medications: median adherence rates of 35%, 82%, and 130%. These three groups differed significantly for sanctification of their child's body and self-efficacy.

Conclusions: Our results indicated that parents in each group shared psychosocial and religious and/or spiritual factors that differentiated them. Therefore, conversations about adherence likely should be tailored to baseline adherence patterns. Development of efficacious religious and/or spiritual interventions that promote adherence by caregivers of children with cystic fibrosis may be useful.

Keywords: cystic fibrosis; parents; psychosocial; spirituality; treatment adherence.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
The theory of reasoned action.
Figure 2.
Figure 2.
Participant enrollment diagram.
Figure 3.
Figure 3.
Four-cluster model of parents’ adherence to their child’s prescribed daily frequency of airway clearance treatments.
Figure 4.
Figure 4.
Three-cluster model of parents’ adherence to their child’s prescribed daily frequency of nebulized medication treatments.
See this image and copyright information in PMC

References

    1. Quittner AL, Zhang J, Marynchenko M, Chopra PA, Signorovitch J, Yushkina Y, Riekert KA. Pulmonary medication adherence and health-care use in cystic fibrosis. Chest. 2014;146:142–151. - PubMed
    1. Sawicki GS, Tiddens H. Managing treatment complexity in cystic fibrosis: challenges and opportunities. Pediatr Pulmonol. 2012;47:523–533. - PubMed
    1. Berg JS, Dischler J, Wagner DJ, Raia JJ, Palmer-Shevlin N. Medication compliance: a healthcare problem. Ann Pharmacother. 1993;27(9 Suppl):S1–S24. - PubMed
    1. Modi AC, Lim CS, Yu N, Geller D, Wagner MH, Quittner AL. A multi-method assessment of treatment adherence for children with cystic fibrosis. J Cyst Fibros. 2006;5:177–185. - PubMed
    1. Modi AC, Cassedy AE, Quittner AL, Accurso F, Sontag M, Koenig JM, Ittenbach RF. Trajectories of adherence to airway clearance therapy for patients with cystic fibrosis. J Pediatr Psychol. 2010;35:1028–1037. - PubMed

Publication types

MeSH terms