title: Stroke and TIA survivors' cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk.
abstract: Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains - specifically, affective illness, cognitive illness, affective treatment and cognitive treatment - for predicting stroke and transient ischemic attack (TIA) survivors' adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed these domains among stroke/TIA survivors (n = 600), and conducted correlation and regression analyses with concurrent and prospective outcomes to determine the relative importance of each cognitive and affective domain for adherence and stroke risk. As hypothesised, patients' affective treatment responses explained the greatest unique variance in baseline and six-month adherence reports (8 and 5%, respectively, of the variance in adherence, compared to 1-3% explained by other domains). Counter to hypotheses, patients' cognitive illness beliefs explained the greatest unique variance in baseline and six-month objective categorised stroke risk (3 and 2%, respectively, compared to 0-1% explained by other domains). Results indicate that domain type (i.e. cognitive and affective) and domain referent (illness and treatment) may be differentially important for providers to assess when treating patients for stroke/TIA. More research is required to further distinguish between these domains and their relative importance for stroke prevention.
authors.affiliation: a Psychology Department , Iowa State University , Ames , IA , USA.
authors.forename: L Alison
authors.initials: LA
authors.lastname: Phillips
authors.forename: Michael A
authors.initials: MA
authors.lastname: Diefenbach
authors.forename: Jessica
authors.initials: J
authors.lastname: Abrams
authors.forename: Carol R
authors.initials: CR
authors.lastname: Horowitz
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D005260:Female; D005544:Forecasting; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D002546:Ischemic Attack, Transient / Q000523:psychology / Q000628:therapy*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D018570:Risk Assessment; D055502:Secondary Prevention; D020521:Stroke / Q000523:psychology / Q000628:therapy*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data
keywords: affective responses; chronic illness; cognitive beliefs; health beliefs; medication adherence