title: Pediatric compliance and the roles of distinct treatment characteristics, treatment attitudes, and family stress: a preliminary report.
abstract: Much research and clinical practice derives from the assumption that there is a set of psychological-social variables that commonly influence medical (non)compliance. This assumption may lead to overly general strategies for managing specific illnesses in children with chronic illness. With this concern in mind, a study was made of health provider ratings of compliance, treatment attitudes, and illness-related family stress for three pediatric cohorts (N = 75, ages 8 to 20 years): boys with hemophilia (n = 31), sickle cell disease (n = 22), or asthma (n = 22). Between-group differences were found on compliance and treatment attitudes (p < .05), with patients with sickle cell demonstrating greater treatment cooperation than their counterparts and boys with hemophilia expressing more positive outlooks on medical advice and about health outcomes (Newman-Keuls test, p < .05). Positive treatment attitudes were associated with specific compliance behaviors for boys with hemophilia (p < .045) but not for other groups.
authors.affiliation: Division of Ambulatory Medicine, Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Van Sciver
authors.forename: E J
authors.initials: EJ
authors.lastname: D'Angelo
authors.forename: L
authors.initials: L
authors.lastname: Rappaport
authors.forename: A D
authors.initials: AD
authors.lastname: Woolf
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000523:psychology* / Q000628:therapy; D001249:Asthma / Q000523:psychology* / Q000628:therapy; D001294:Attitude to Health; D002648:Child; D005190:Family / Q000523:psychology*; D006467:Hemophilia A / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D010553:Personality Development; D010817:Physician-Patient Relations; D012803:Sick Role; D013315:Stress, Psychological / Q000150:complications*; D016896:Treatment Outcome