On the problem of differentiated assessment of treatment adherence among patients undergoing coronary artery bypass surgery

Abstract

Low adherence to treatment of chronic diseases, in particular coronary heart disease, is noted as a circumstance leading to a negative outcome. The issue of assessing adherence to treatment remains unsolved, especially due to the necessity of taking into account a whole range of behavioral aspects (control of blood pressure, diet, recommended physical activity, etc.), not just adherence to pharmacotherapy, which is associated with the characteristics of the treatment of the disease. The study of patient’s behavior in the therapy process, as well as a differential assessment of his/her adherence to different kinds of treatment, is a complex task that must be faced by the multidisciplinary team managing the patient: the physician and the clinical psychologist. Thus, the aim of the study consisted in developing a specialized questionnaire for assessing the behavior associated with adherence to treatment among patients with cardiac pathology in the postoperative period. The questionnaire developed by the authors is provided in the appendix. A detailed analysis of the data obtained from a group of 103 patients suffering from coronary heart disease and undergoing coronary artery bypass surgery, using the above-mentioned 8-scale questionnaire, confirmed that all the studied behavioral aspects are significant for determining adherence to treatment. As a result of the factor analysis of the questionnaire parameters, three main factors were obtained, which can be used for a more differentiated description of patients’ behavior in the therapy process. These factors were labeled as “medical”, “physical condition”, and “bad habits”. The article illustrates a practical example of how a patient sample can be divided according to the above factors for further detailed study of their psychological and clinical characteristics.