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Type :thesis
Subject :BF Psychology
Main Author :Nor Firdous Mohamed
Title :Investigating psychosocial factors and medication adherence among Malaysians with Coronary Heart Disease using mixed methods
Place of Production :Tanjong Malim
Publisher :Fakulti Pembangunan Manusia
Year of Publication :2023
Corporate Name :Universiti Pendidikan Sultan Idris
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Abstract : Universiti Pendidikan Sultan Idris
Coronary heart disease (CHD) is the leading cause of death in Malaysia, however, adherence to medications remains the main issue in achieving optimal treatment outcomes. This study was conducted to explore the psychosocial relationships model on medication adherence among patients with CHD in Malaysia. The study involved the sequential mixed method design; Firstly, it explores the – psychosocial factors associated with medication adherence through a qualitative interview on the CHD patient’s treatment experiences (N=22, 88% males) as well as their family caregivers (N=15). Secondly, questionnaires based on the qualitative findings were developed and validated; and finally, the relationships between the psychosocial factors with medication adherence among the CHD patients (N=235, 73.6% males) were determined. Qualitative findings revealed five factors such as psychosocial beliefs, doctor-patient relationship, seeking information behaviour, social support needs, and lifestyle changes. Following the qualitative findings, two questionnaires were developed and validated which were – the CHD-specific modern medication use questionnaire (CHD-MMUQ) and the CHD-specific complementary alternative medication use questionnaire (CHD-CAMQ). Finally, the multivariate logistic regression analysis was conducted and suggests psychosocial factors such as low concern-specific beliefs on medications, gender, ethnicity, diet control, and performing spiritual practices were statistically significant to predict adherence to medication (χ2 = 61.6, df = 8, N = 235, P< 0.001). The diagnostic test suggested that the Nagelkerke pseudo-R-square of the coefficient of determination indicated that approximately 33% of the factors in CHD patients were related to medication adherence, the model fits well with our data. Assessment of the possible moderating influence of medication adherence suggested that CHD patients who controlled diet based on ethnicity differences (such as Indian ethics) were associated with significant medication adherence, but they were poorly associated with medication adherence if an individual was not controlling their diets. Overall, the final results suggested that besides the patient’s treatment psychosocial beliefs, differences based on ethnic practices such as diet control are important factors to be considered for better medication adherence outcomes.

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