Therapeutic adherence to oral medication regimens by adolescents with cancer. II. Clinical and psychologic correlates.
The focus of our study was to identify specific demographic, treatment, and psychologic factors that may differentiate patients who complied with cancer therapy from those who did not. In a companion study, bioassay techniques revealed frequent nonadherence to oral medication regimens among 50 adolescents and young adults with acute lymphoblastic leukemia or Hodgkin disease. In this sample, compliers and noncompliers did not differ with respect to either demographic variables (age, gender) or treatment variables (treatment duration, continuity, complexity, or parental involvement). Psychologic variables were assessed in 34 patients. Patients who adhered poorly to the therapeutic regimen had significantly less developed concepts of the illness (specifically, concepts of causality and prognosis), less perceived vulnerability (especially as related to subclinical disease), higher levels of denial as a psychologic defense, and less cohesive future orientation. The perceived health locus of control was not a significant factor. The results suggest that patients construct their own subjective view of the illness and its treatment, which then has implications for adherence to medication regimens.
Tamaroff
M H
MH
Department of Pediatrics and Psychiatry, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, New York.
Festa
R S
RS
Adesman
A R
AR
Walco
G A
GA
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D001294:Attitude to Health; D003717:Denial, Psychological; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D010406:Penicillins / Q000008:administration & dosage* / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000523:psychology; D011241:Prednisone / Q000008:administration & dosage* / Q000627:therapeutic use
D010406:Penicillins; D011241:Prednisone