Project EASE: a study to test a psychosocial model of epilepsy medication management

The purpose of this study was to test a psychosocial model of medication self-management among people with epilepsy. This model was based primarily on social cognitive theory and included personal (self-efficacy, outcome expectations, goals, stigma, and depressive symptoms), social (social support), and provider (patient satisfaction and desire for control) variables. Participants for the study were enrolled at research sites in Atlanta, Georgia, and Boston, Massachusetts and completed computer-based assessments that included measures of the study variables listed above. The mean age of the 317 participants was 43.3 years; about 50% were female, and 81%white. Self-efficacy and patient satisfaction explained the most variance in medication management. Social support was related to self-efficacy; stigma to self-efficacy and depressive symptoms; and self-efficacy to outcome expectations and depressive symptoms. Findings reinforce that medication-taking behavior is affected by a complex set of interactions among psychosocial variables.

[1]  S. Kaplan,et al.  Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease , 1989, Medical care.

[2]  R. Mermelstein,et al.  Goal setting and behavior change in a smoking cessation program , 1994, Cognitive Therapy and Research.

[3]  Lynn Ordway,et al.  Antecedents of adherence to medical recommendations: Results from the medical outcomes study , 1992, Journal of Behavioral Medicine.

[4]  E. Wyllie,et al.  The Treatment of Epilepsy: Principles and Practice , 1997 .

[5]  C Desforges,et al.  Dose Frequency and Dose Interval Compliance with Multiple Antiepileptic Medications During a Controlled Clinical Trial , 1995, Epilepsia.

[6]  C Weinert,et al.  The PRQ—A Social Support Measure , 1981, Nursing research.

[7]  P. Estabrooks,et al.  Exercise-related goals and self-efficacy as correlates of aquatic exercise in individuals with arthritis. , 2003, Arthritis and rheumatism.

[8]  P. Conrad,et al.  IN THE CLOSET WITH ILLNESS: EPILEPSY, STIGMA POTENTIAL AND INFORMATION CONTROL* , 1980 .

[9]  M. Browne,et al.  Alternative Ways of Assessing Model Fit , 1992 .

[10]  W. Dudley Gender differences in goal setting for HIV prevention among college students. , 2003 .

[11]  Shope Jt Compliance in children and adults: review of studies. , 1988 .

[12]  M. Amir,et al.  Self‐Efficacy and Social Support as Mediators in the Relation Between Disease Severity and Quality of Life in Patients with Epilepsy , 1999, Epilepsia.

[13]  D. A. Walsh,et al.  Nicotine dependence, depression, and the moderating role of goal cognitions. , 2001, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[14]  V. Conn Older adults and exercise: path analysis of self-efficacy related constructs. , 1998, Nursing research.

[15]  H. Kyngäs Compliance with health regimens of adolescents with epilepsy , 2000, Seizure.

[16]  R. Devellis,et al.  Patients' perceptions of their clinical interactions: development of the multidimensional desire for control scales , 1989 .

[17]  R. Weiss The provisions of social relationships , 1974 .

[18]  Robert C. MacCallum,et al.  SPECIFICATION SEARCHES IN COVARIANCE STRUCTURE MODELING , 1986 .

[19]  J. S. Long,et al.  Testing Structural Equation Models , 1993 .

[20]  L. Radloff The CES-D Scale , 1977 .

[21]  C. Weinert,et al.  Measuring Social Support with the Personal Resource Questionnaire , 1987, Western journal of nursing research.

[22]  C. Diiorio,et al.  Epilepsy self-management: partial replication and extension. , 1994, Research in nursing & health.

[23]  P. Spinhoven,et al.  Psychiatric comorbidity in epilepsy , 2005, Epilepsy & Behavior.

[24]  F. Haaijer-Ruskamp Compliance in Epilepsy , 1989 .

[25]  L. Moon,et al.  Relationships among self-efficacy, outcome expectancy, and postoperative behaviors in total joint replacement patients. , 2000, Orthopedic nursing.

[26]  C. L. Mandle,et al.  Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients , 1999, Pain.

[27]  N. Krawiecki,et al.  Factors related to adherence to medication regimens in pediatric seizure patients. , 1990, Journal of pediatric psychology.

[28]  C. Hinkin,et al.  Medication adherence among HIV+ adults , 2002, Neurology.

[29]  S. G. Bryant,et al.  Determinants of Compliance in Epileptic Outpatients , 1981, Drug intelligence & clinical pharmacy.

[30]  A. Oun,et al.  Felt stigma and impact of epilepsy on employment status among Estonian people: exploratory study , 2000, Seizure.

[31]  B. A. Boyce,et al.  The Effects of Assigned and Self-Set Goals on Task Performance , 1994 .

[32]  E. Goffman Stigma; Notes On The Management Of Spoiled Identity , 1964 .

[33]  C. Diiorio,et al.  Epilepsy self-management: a test of a theoretical model. , 1996, Nursing research.

[34]  A. d’Arminio Monforte,et al.  Medication adherence among HIV+ adults: Effects of cognitive dysfunction and regimen complexity , 2003, Neurology.

[35]  G. Huster,et al.  Identifying risk factors for maternal depression in families of adolescents with epilepsy. , 2002, Journal for specialists in pediatric nursing : JSPN.

[36]  N. Buchanan,et al.  Epilepsy: patient perceptions of their condition , 1992, Seizure.

[37]  C. Diiorio,et al.  Cognitive-perceptual factors associated with antiepileptic medication compliance. , 1991, Research in nursing & health.

[38]  Ron Coriell,et al.  Doing Unto Others , 1980 .

[39]  M. Dimatteo,et al.  The Role of Patient Participation in the Doctor Visit: Implications for adherence to diabetes care , 1996, Diabetes Care.

[40]  B. Manteuffel,et al.  Self-Efficacy and Social Support in Self-Management of Epilepsy , 1992, Western journal of nursing research.

[41]  E. Vartiainen,et al.  Depression and smoking cessation: the role of motivation and self-efficacy. , 2000, Addictive behaviors.

[42]  R. S. Klingle,et al.  Silent partners in medical care: a cross-cultural study of patient participation. , 1996, Health communication.

[43]  R. Dowse,et al.  Outpatient compliance with theophylline and phenytoin therapy. , 1991, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[44]  Vicki S Conn,et al.  Older women and exercise: explanatory concepts. , 2003, Women's health issues : official publication of the Jacobs Institute of Women's Health.

[45]  C. Iorio Epilepsy Self-Management , 1997 .

[46]  B. Manteuffel,et al.  The development and testing of an instrument to measure self-efficacy in individuals with epilepsy. , 1992, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[47]  Ron D. Hays,et al.  The structure of patient satisfaction with outpatient medical care , 1993 .

[48]  A. Wu,et al.  Depression Is a Risk Factor for Suboptimal Adherence to Highly Active Antiretroviral Therapy , 2002, Journal of acquired immune deficiency syndromes.

[49]  K. Fiscella,et al.  Association of perceived family criticism with health behaviors. , 1999, The Journal of family practice.

[50]  A. Bandura Self-Efficacy: The Exercise of Control , 1997, Journal of Cognitive Psychotherapy.

[51]  Deborah Buck,et al.  Quality of Life of People with Epilepsy: A European Study , 1997, Epilepsia.

[52]  G. Huster,et al.  Development of Scales to Measure Psychosocial Care Needs of Children with Seizures and Their Parents , 1998, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[53]  G. Baker,et al.  Factors influencing compliance with antiepileptic drug regimes , 1997, Seizure.