Journal of psychosomatic research · 2025
Path analysis of medication adherence in schizophrenia patients based on the extended theory of planned behavior: A cross-sectional study.
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Li Xuping, Xiao Shuiyuan, Sun Yajun, Zheng Ying, Hao Yibin, Tian Gang
Аннотация
BACKGROUND: Medication adherence is a significant challenge among community-dwelling patients with schizophrenia. Understanding the influencing factors through the lens of behavioral theory can provide valuable guidance for designing effective interventions to improve medication adherence.
OBJECTIVES: This study aimed to identify the factors associated with medication adherence and the underlying mechanisms, based on the extended Theory of Planned Behavior (TPB), among community-dwelling patients with schizophrenia in China.
METHODS: Medication adherence was measured using the seven-day recall method. Medication attitudes were assessed using the Drug Attitude Inventory-10-Item Version, perceived behavioral control was measured with the Self-Efficacy for Appropriate Medication Use Scale, and subjective norms, intention, and supervision were evaluated using self-developed items. Path analysis was conducted to test the hypotheses based on the extended TPB.
RESULTS: A total of 468 community-dwelling patients with schizophrenia were surveyed, and 81.20 % of them demonstrated adherent. Intention (standardized effect: 0.897) and supervision (standardized effect: 0.084) were directly associated with medication adherence. Attitude (standardized effect: 0.268, computed as 0.299 × 0.897), subjective norms (standardized effect: 0.283, computed as 0.316 × 0.897), and perceived behavioral control (standardized effect: 0.187, computed as 0.208 × 0.897) were indirectly associated with medication adherence through intention.
CONCLUSION: The extended TPB is a suitable model for predicting medication adherence among community-dwelling patients with schizophrenia in China. It provides a robust framework for designing interventions targeting attitude, subjective norms, perceived behavioral control, and supervision to enhance medication adherence.
OBJECTIVES: This study aimed to identify the factors associated with medication adherence and the underlying mechanisms, based on the extended Theory of Planned Behavior (TPB), among community-dwelling patients with schizophrenia in China.
METHODS: Medication adherence was measured using the seven-day recall method. Medication attitudes were assessed using the Drug Attitude Inventory-10-Item Version, perceived behavioral control was measured with the Self-Efficacy for Appropriate Medication Use Scale, and subjective norms, intention, and supervision were evaluated using self-developed items. Path analysis was conducted to test the hypotheses based on the extended TPB.
RESULTS: A total of 468 community-dwelling patients with schizophrenia were surveyed, and 81.20 % of them demonstrated adherent. Intention (standardized effect: 0.897) and supervision (standardized effect: 0.084) were directly associated with medication adherence. Attitude (standardized effect: 0.268, computed as 0.299 × 0.897), subjective norms (standardized effect: 0.283, computed as 0.316 × 0.897), and perceived behavioral control (standardized effect: 0.187, computed as 0.208 × 0.897) were indirectly associated with medication adherence through intention.
CONCLUSION: The extended TPB is a suitable model for predicting medication adherence among community-dwelling patients with schizophrenia in China. It provides a robust framework for designing interventions targeting attitude, subjective norms, perceived behavioral control, and supervision to enhance medication adherence.