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Medication adherence in pediatric renal transplant patients: The role of family functioning and parent health locus of control
Author(s) -
Kraenbring Meghan Marie,
Zelikovsky Nataliya,
Meyers Kevin E. C.
Publication year - 2019
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13346
Subject(s) - medicine , regimen , psychological intervention , autonomy , locus of control , transplantation , disease , quality of life (healthcare) , pediatrics , clinical psychology , psychiatry , developmental psychology , nursing , psychology , political science , law
Children and adolescents with renal disease experience daily social, emotional, and medical challenges. Renal transplantation can help to improve quality of life but requires a lifelong regimen of immunosuppressant medication to maintain health. Adherence to a daily complex regimen can be difficult, particularly for adolescents who are beginning to develop autonomy from caregivers and are faced with a unique set of socio‐emotional challenges. This study examines two factors that have shown to influence adherence in other pediatric populations, namely family functioning and parent health locus of control, from mothers’ perspectives, in predicting medication non‐adherence for adolescents (ages 12‐19 years) 1 year post‐transplant. Non‐adherence was defined as the percentage of missed doses and late doses of the weekly immunosuppressant doses prescribed. Regression results demonstrated that mothers’ perceptions of poorer overall family functioning predicted missed medication doses (Δ R 2 = 0.383, F (7, 21) = 2.570, P = 0.044) with significant contributions in the domains of problem‐solving (β = −0.795, t (21) = −2.927, P = 0.008) and affective involvement (β = 0.872, t (21) = 3.370, P = 0.003). Moreover, mothers who perceived that their adolescent had control over his/her health also predicted more missed medication doses (Δ R 2 = 0.133, F (1, 27) = 5.155, P = 0.031). Important implications for these findings include implementation of family‐based interventions that promote developmentally appropriate skills for adolescents and cultivate emotional involvement within the family.