title: Medical and psychosocial associates of nonadherence in adolescents with cancer.
abstract: The current study examined adherence to medication regimens among adolescents with cancer by applying the Pediatric Self-Management Model. Adolescents and their parents reported on adherence to medication, reasons for nonadherence, and patient-, family-, and community-level psychosocial variables. Adolescent- and parent-reported adherence were significantly correlated, with about half of the sample reporting perfect adherence. The majority reported "just forgot" as the most common reason for missed medication. Patient-, family-, and community-level variables were examined as predictors of adherence. With regard to individual factors, adolescents who endorsed perfect adherence reported a greater proportion of future-orientated goals and spent fewer days in outpatient clinic visits. For family factors, adolescents who endorsed perfect adherence reported greater social support from their family and were more likely to have a second caregiver who they perceived as overprotective. The community-level variable (social support from friends) tested did not emerge as a predictor of adherence. The results of this study provide direction for intervention efforts to target adolescent goals and family support in order to increase adolescent adherence to cancer treatment regimens.
authors.affiliation: Indiana University School of Nursing, Indianapolis, IN, USA hullmann@iupui.edu.
authors.forename: Stephanie E
authors.initials: SE
authors.lastname: Hullmann
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Lauren D
authors.initials: LD
authors.lastname: Brumley
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Schwartz
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000328:Adult; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010290:Parents / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D055815:Young Adult
keywords: adherence; adolescence; cancer; future orientation; psychosocial