title: Mediating roles of medication-taking self-efficacy and depressive symptoms on self-reported medication adherence in persons with HIV: a questionnaire survey.
abstract: BACKGROUND
  To date, only a few studies have examined the mediating role of self-efficacy on the relationship between depressive symptoms or perceived social support and medication adherence in persons with HIV.
  
  
  OBJECTIVE
  The purpose of this study was to examine the impact of perceived social support, depressive symptoms and medication-taking self-efficacy on self-reported medication adherence in persons with HIV. A proposed comprehensive model included three mediation hypotheses in order to examine the mediating roles of medication-taking self-efficacy and depressive symptoms.
  
  
  METHODS
  Baseline data from "Adherence to Protease Inhibitors" were used. The 215 persons with HIV aged 19-61 (mean=40.7, S.D.=7.58) were recruited from multiple sites in Pittsburgh, PA (USA) and through self-referral. The participants were assessed using the Beck Depression Inventory, Interpersonal Support Evaluation List, the Medication Taking Self-Efficacy Scale, and the modified Morisky Self-report Medication Taking Scale. Structural equation modeling (EQS version 6.1) was used. The Satorra-Bentler Scaled chi(2) test statistics (S-B chi(2)), Comparative Fit Index (CFI), and the Standardized Root Mean Squared Residual (SRMR) were used to assess the fit of a comprehensive model including three mediation hypotheses.
  
  
  RESULTS
  A comprehensive model with the three hypotheses showed a good model fit (S-B chi(2) (24, N=215)=69.06, p<.001; CFI=.95; SRMR=.057). Medication adherence self-efficacy fully mediated the prediction of self-reported medication adherence by perceived social support and depressive symptoms. Depressive symptoms partially mediated the prediction of medication-taking self-efficacy by perceived social support.
  
  
  CONCLUSIONS
  The findings of this study provide researchers with increased understanding of the mediating role of medication-taking self-efficacy beliefs between selected psychological variables and self-reported medication adherence in persons with HIV. Future studies need to test the moderating effect of gender, ethnicity and risk factors for HIV on this model and the intervention effect of self-efficacy beliefs using longitudinal data.
authors.affiliation: Chung-Ang University, Department of Nursing School of Medicine, Seoul 156-756, South Korea. euc6@cau.ac.kr
authors.forename: Eunseok
authors.initials: E
authors.lastname: Cha
authors.forename: Judith A
authors.initials: JA
authors.lastname: Erlen
authors.forename: Kevin H
authors.initials: KH
authors.lastname: Kim
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
authors.forename: Donna
authors.initials: D
authors.lastname: Caruthers
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000517:prevention & control / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D017320:HIV Protease Inhibitors / Q000191:economics / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D015404:Nursing Methodology Research; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010414:Pennsylvania; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D017010:Reminder Systems; D012646:Self Administration / Q000523:psychology; D020377:Self Efficacy; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires
chemical_list: D017320:HIV Protease Inhibitors