title: Factors influencing opioid-taking self-efficacy and analgesic adherence in Taiwanese outpatients with cancer.
abstract: OBJECTIVE
  Although research has suggested that medication adherence rates are lower than what is needed to achieve optimal pain control, the role of patient beliefs and attitudes in influencing opioid adherence has rarely been examined. Perceived self-efficacy is reported to be an important construct in predicting and enhancing adherence behaviour. The purpose of this study was to explore the relationship between opioid-taking self-efficacy, opioid beliefs, adherence behaviours, and pain experience amongst Taiwanese cancer outpatients.
  
  
  METHODS
  The cross-sectional study included 92 oncology outpatients in two teaching hospitals in the Taipei area of Taiwan. The research instruments included the Opioid-Taking Self-Efficacy Scale-Cancer (OTSES-CA), the Pain Opioid Analgesic Beliefs Scale-Cancer (POABS-CA), opioid adherence, and the Brief Pain Inventory-Chinese (BPI-Chinese).
  
  
  RESULTS
  Opioid-taking self-efficacy demonstrated a significant positive relationship with patients' opioid adherence (r=0.22, p<0.05) and pain relief (r=0.35, p<0.01), while also demonstrating a significant positive correlation with worst pain (r=0.25, p<0.05). In addition, the more negative beliefs regarding opioids the patient had, the worse their adherence to around the clock analgesic regimen (r=-0.30, p<0.01). Multivariate analysis identified opioid-taking self-efficacy continued to have a significant independent influence on opioid adherence and pain relief, after controlling for key demographic variables. Self-efficacy accounted for 4% (R(inc) (2)=0.04, p=0.043) of the variance and opioid beliefs accounted for 8% (R(inc) (2)=0.08, p=0.007) of the variance in opioid adherence. Multivariate analysis also identified that opioid-taking self-efficacy accounted for 11% (R(inc) (2)=0.11, p=0.001) of the variance in pain relief, but opioid beliefs did not continue to have an independent effect for this outcome.
  
  
  CONCLUSIONS
  The study highlights the potential importance of a patient's self-efficacy beliefs in adherence to medication and key pain outcomes.
authors.affiliation: Department of Nursing, National Taipei College of Nursing, Taipei, Taiwan. shuyuan@ntcn.edu.tw
authors.forename: Shu-Yuan
authors.initials: SY
authors.lastname: Liang
authors.forename: Patsy
authors.initials: P
authors.lastname: Yates
authors.forename: Helen
authors.initials: H
authors.lastname: Edwards
authors.forename: Shiow-Luan
authors.initials: SL
authors.lastname: Tsay
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006784:Hospitals, Teaching; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010147:Pain Measurement / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D020377:Self Efficacy; D013624:Taiwan
chemical_list: D000701:Analgesics, Opioid