Patient Preference And Adherence[JOURNAL]
Sun
200 papers
eHealth Literacy and Its Associated Factors in Patients with Gestational Diabetes Mellitus: A Cross-Sectional Study.
Guo S, Xie C, Shi S … +4 more , Leng W, Zhou L, Xiao J, Cai S
Patient Prefer Adherence · 2026 · PMID 41948313 · Full text
OBJECTIVE: To assess the level of eHealth literacy and its associated factors among women with gestational diabetes mellitus (GDM), and to inform the development of targeted interventions. METHODS: From December 2024 to...
OBJECTIVE: To assess the level of eHealth literacy and its associated factors among women with gestational diabetes mellitus (GDM), and to inform the development of targeted interventions. METHODS: From December 2024 to March 2025, a total of 239 patients with gestational diabetes mellitus attending the obstetric outpatient clinic of a maternal and child health hospital in Guangzhou were conveniently sampled. Data were collected using a general information questionnaire, the eHealth Literacy Scale for Pregnant Women, the Pregnancy-Related Anxiety Questionnaire, the Edinburgh Postnatal Depression Scale, and the Perceived Social Support Scale. RESULTS: The mean total eHealth literacy score among patients with gestational diabetes mellitus was 79.05±8.61. Multiple linear regression analysis indicated that age, educational level, frequency of health information searching, anxiety, and perceived social support were influencing factors of eHealth literacy. CONCLUSION: The level of eHealth literacy among patients with gestational diabetes mellitus was moderate to high and was influenced by multiple factors. Tailored recommendations for accessing appropriate online health information platforms, based on patients' individual characteristics and needs, may help improve their eHealth literacy.
Erratum: The Impact of Psychological Nursing Combined with Respiratory Training on Mental Health, Pulmonary Function, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease: A Retrospective Analysis [Corrigendum].
Patient Prefer Adherence · 2026 · PMID 41948312 · Full text
[This corrects the article DOI: 10.2147/PPA.S561019.].
[This corrects the article DOI: 10.2147/PPA.S561019.].
User-Centered Design of Strategies for Improving Cervical Cancer Screening Literacy Among Rural Women Living with HIV in Eastern Uganda.
Namutundu J, Nakalembe M, Kiguli J … +4 more , Wanyenze RK, Semitala FC, Ejalu DL, Nakku-Joloba E
Patient Prefer Adherence · 2026 · PMID 41948311 · Full text
BACKGROUND: The uptake of cervical cancer screening services among rural Women Living with HIV (WLHIV) attending several rural public facilities in Eastern Uganda is low at less than 50% of the target. This gap is largel...
BACKGROUND: The uptake of cervical cancer screening services among rural Women Living with HIV (WLHIV) attending several rural public facilities in Eastern Uganda is low at less than 50% of the target. This gap is largely influenced by low screening literacy among these women, difficulties in accessing, understanding and applying cervical cancer screening information due to multiple barriers, including limited education, low socioeconomic status, misconceptions, and fear. Therefore, context-specific and culturally appropriate strategies are needed to overcome these barriers. This study engaged rural WLHIV in Eastern Uganda to co-design three strategies to improve their cervical cancer screening literacy. METHODS: This participatory research combined the User-Centered Design (UCD) approach with co-design workshops to design the three strategies. Participants included 16 rural WLHIV from four rural public health facilities in Mayuge and Namayingo districts who had participated in prior studies that identified and selected these strategies. This process involved the ideation and implementation phases of the UCD approach. It was led by a medical illustrator and a Sexual and a Behavioral Change Communication specialist, supported by two healthcare providers. RESULTS: Two IEC charts, one on the importance of cervical cancer screening and the other addressing key misconceptions regarding cervical cancer screening. Both IEC charts had colorful pictures, and few texts in local language, Luganda, explaining the pictures. Two peer educators were trained to provide cervical cancer screening education, address misconceptions about cervical cancer screening, and encourage women to undergo cervical cancer screening. A ten-minute cervical cancer screening education video was designed, comprising a midwife providing cervical cancer screening education and a trained peer educator interacting with a client. CONCLUSION: Integrating co-design and UCD approaches facilitated the design of context-specific strategies that incorporated preferences for rural WLHIV and targeted barriers to cervical cancer-screening literacy among these women.
Knowledge, Attitude, Practice, and Awareness Regarding Disease Management Among Patients with Chronic Lower Limb Ischemia: A Cross-Sectional Study.
Wang F, Chen X, Jiang Y … +5 more , Liu Y, Li Y, Yang X, Zhang H, Gan X
Patient Prefer Adherence · 2026 · PMID 41937943 · Full text
PURPOSE: This study aims to investigate knowledge, attitude, practice (KAP), and disease awareness among patients with chronic lower limb ischemia. PATIENTS AND METHODS: This cross-sectional study was conducted between N...
PURPOSE: This study aims to investigate knowledge, attitude, practice (KAP), and disease awareness among patients with chronic lower limb ischemia. PATIENTS AND METHODS: This cross-sectional study was conducted between November 2024 and January 2025 at the Second Affiliated Hospital of Chongqing Medical University. A self-administered questionnaire, with good internal consistency (Cronbach's α = 0.917), was used to assess knowledge, attitude, and practice, while the Brief Illness Perception Questionnaire measured awareness. RESULTS: Among 491 participants (73.7% male), most were aged 70-79 years (38.7%), and 41.5% had a primary school education or below. Nearly half (48.1%) had ischemia for 2-3 years. The mean knowledge, attitude, practice, and awareness scores were 8.71 ± 5.42, 31.55 ± 2.92, 31.47 ± 4.88, and 31.68 ± 5.03, respectively. Significant correlations were observed between knowledge and attitude (r = 0.513, P < 0.001), practice (r = 0.448, P < 0.001), and awareness (r = 0.175, P < 0.001). Attitude also correlated with practice (r = 0.331, P < 0.001) and awareness (r = 0.227, P < 0.001). Path analysis indicated that knowledge directly affected attitude (β = 0.522, P < 0.001), awareness (β = 0.164, P < 0.001), and practice (β = 0.356, P < 0.001), while attitude directly affected practice (β = 0.159, P < 0.001), knowledge also indirectly affected practice through attitude (β = 0.083, P = 0.001). CONCLUSION: Patients with chronic lower limb ischemia showed limited knowledge but generally maintained positive attitudes, proactive practices, and moderate awareness toward disease management. Enhancing awareness alongside knowledge may help improve overall self-management and clinical outcomes.
Stigma and Its Influencing Factors Among Chinese Patients with Thyroid-Associated Ophthalmopathy: A Cross-Sectional Study.
Li J, Zhang X, Ren J
Patient Prefer Adherence · 2026 · PMID 41937942 · Full text
PURPOSE: To understand the current situation of stigma among patients with thyroid-associated ophthalmopathy (TAO) in China and analyze its influencing factors, to provide a theoretical basis for medical staff to provide...
PURPOSE: To understand the current situation of stigma among patients with thyroid-associated ophthalmopathy (TAO) in China and analyze its influencing factors, to provide a theoretical basis for medical staff to provide targeted intervention measures. PATIENTS AND METHODS: From March to December 2024, 217 patients with TAO were recruited from a tertiary care general hospital in Sichuan Province, China, using a convenience sampling method. Participants completed several assessments, including a general information questionnaire, the Chinese version of the Stigma Scale for Chronic Illness (SSCI), the Medical Coping Modes Questionnaire (MCMQ), and the Huaxi Emotional Distress Index (HEI). Statistical analysis was performed using SPSS 27.0. A generalized linear model was constructed to analyze the factors influencing stigma in TAO patients, using general demographic characteristics, medical coping style scores, and emotional distress scores as independent variables, and stigma scores as the dependent variable. RESULTS: This cross-sectional study included 217 TAO patients, predominantly female (72.4%), with an average age of 45.06±11.92 years. The stigma score among TAO patients in China was 34.00 (26.00, 47.00). Univariate analysis and multivariate analysis showed that male gender (=-3.736, 95% CI: -6.755, -0.717), aged 18-35 years (=9.182, 95% CI: 1.899, 16.464), with a junior secondary school education (=6.510, 95% CI: 2.434, 10.587), less than 5 ophthalmology visits within a year (=-6.730, 95% CI: -11.631, -1.829), mild (=-10.098, 95% CI: -15.482, -4.715) and moderately severe (=-7.406, 95% CI: -12.469, -2.343) TAO grading, resignation coping (=1.029, 95% CI: 0.407, 1.651), and emotional distress (=0.405, 95% CI: 0.129, 0.682) had significant difference on stigma (<0.05). The gender-stratified analysis revealed heterogeneity in the factors influencing stigma between men and women, indicating a need for precise, group-specific intervention strategies. CONCLUSION: Gender, age, education level, number of ophthalmology visits within a year, classification of TAO, resignation coping, and emotional distress are the influencing factors of stigma for TAO patients in China. It is suggested that medical staff should incorporate stigma assessment into clinical routine screening of TAO patients, and pay attention to the emotional state of high-risk groups, so as to identify individuals with high stigma level in time and provide necessary psychological support and intervention.
Prevalence and Determinants of Self‑Medication Among Adult Outpatients in a Rural Health Facility in Northern Uganda: A Cross‑Sectional Study.
Watuwa PP, Opito R, Okello S … +7 more , Asapo RM, Baguma I, Okello J, Onap O, Ayikobua ET, Odung T, Lubogo P
Patient Prefer Adherence · 2026 · PMID 41937941 · Full text
BACKGROUND: Self-medication, defined as the use of medicines without prescription or supervision from a qualified healthcare provider, is common in low-resource settings. Rural communities may be disproportionately affec...
BACKGROUND: Self-medication, defined as the use of medicines without prescription or supervision from a qualified healthcare provider, is common in low-resource settings. Rural communities may be disproportionately affected due to limited healthcare access, yet empirical data from Uganda remain scarce. This study aimed to fill this gap by assessing the prevalence, patterns, and factors associated with self-medication among outpatients in a rural health facility in Northern Uganda. METHODS: A cross-sectional study was conducted among 248 adult outpatients at Alebtong Health Center IV using systematic random sampling. Data were collected via a structured interviewer-administered questionnaire capturing sociodemographic characteristics, patient-related factors, and health facility-related factors. Modified Poisson regression with robust standard errors was used to determine factors associated with self-medication, with significance set at p < 0.05. RESULTS: Of 248 participants, 182 (73.4%) reported self-medication. The most frequently used drug classes were analgesics (36.3%), antibiotics (22.0%), and antimalarials (15.4%). Factors significantly associated with self-medication included tertiary education (aPR: 1.48; 95% CI: 1.04-2.09), being self-employed (aPR: 1.62; 95% CI: 1.21-2.18) or a student (aPR: 1.46; 95% CI: 1.07-2.00), inability to obtain an appointment with a health worker (aPR: 1.36; 95% CI: 1.20-1.55), and the lack of privacy during consultations (aPR: 1.21; 95% CI: 1.08-1.36). CONCLUSION: Self-medication was highly prevalent among outpatients, particularly among individuals with tertiary education, the self-employed, and students. Limited access to health workers and the lack of privacy during consultations were also associated with this practice. Findings highlight the need for improved healthcare access, enhanced patient privacy, and greater involvement of frontline health workers in community education to promote responsible medicine use. As a cross-sectional study, causal relationships cannot be inferred.
Knowledge, Attitude, and Practice of Chronic Prostatitis Patients Regarding Electrophysiological Therapy in a Chinese Tertiary Hospital: A Cross-Sectional SEM Study.
Chi Z, Wan Q, Zhang Y … +5 more , Zhu T, Liu G, Lin W, Hong X, Zhang Y
Patient Prefer Adherence · 2026 · PMID 41937940 · Full text
PURPOSE: This study aimed to examine the knowledge, attitudes, and practices (KAP) of patients with chronic prostatitis (CP) concerning electrophysiological therapy. METHODS: A cross-sectional survey was conducted at Sha...
PURPOSE: This study aimed to examine the knowledge, attitudes, and practices (KAP) of patients with chronic prostatitis (CP) concerning electrophysiological therapy. METHODS: A cross-sectional survey was conducted at Shantou Central Hospital between March 2025 and June 2025. Data were collected using a structured, self-administered questionnaire specifically designed to assess the three domains of KAP. To investigate the interrelationships among knowledge, attitudes, and practices, structural equation modeling (SEM) was employed. RESULTS: A total of 338 valid questionnaires were collected, with a mean age of 39.11 years (standard deviation: ±10.56). Their knowledge, attitude, and practice scores were 12.04 ± 6.40 (possible range: 0-24), 23.87 ± 6.86 (possible range: 10-50), and 25.41 ± 11.30 (possible range: 10-50), respectively. SEM analysis showed the negative direct effect of knowledge on both attitude (β = -0.344, P = 0.01), as well as the positive direct effect of attitude on practice (β = 0.494, P = 0.016); furthermore, knowledge negatively and indirectly affected practice through attitude (β = -0.17, P = 0.019). CONCLUSION: Patients diagnosed with CP demonstrated insufficient knowledge, negative attitudes, and suboptimal practices regarding electrophysiological therapy. These findings may help inform the design of patient education strategies and highlight the importance of considering behavioral and perceptual factors when promoting non-pharmacological therapies. The results should be interpreted in light of the single-center design and self-reported data.
Artificial Intelligence in Medication Adherence: A National Assessment of Knowledge, Attitudes, and Perceptions Among Chronic Disease Patients in Jordan.
Merdas ZJH, Abed A, Zakaria ZZ … +5 more , Abu Assab M, Abu Dayyih W, Almbaideen WA, Zakaraya Z, Bustami M
Patient Prefer Adherence · 2026 · PMID 41937939 · Full text
PURPOSE: To assess knowledge, attitudes, and perceptions toward AI-based medication adherence tools in a national cross-sectional survey among Jordanian adults with chronic diseases and to identify factors associated wit...
PURPOSE: To assess knowledge, attitudes, and perceptions toward AI-based medication adherence tools in a national cross-sectional survey among Jordanian adults with chronic diseases and to identify factors associated with favorable acceptance. PATIENTS AND METHODS: A national cross-sectional online survey was conducted between January and July 2025 using convenience and snowball sampling and a self-developed, pilot-tested, and content-validated Arabic questionnaire. The questionnaire captured sociodemographic characteristics, digital literacy, chronic disease information, and KAP toward AI-based medication adherence tools. Knowledge was assessed using eight statements describing AI capabilities and rated on a five-point Likert scale, which were recoded dichotomously for scoring (score range 0-8; ≥5 indicating good knowledge). Attitudes and perceptions were measured using five-point Likert scales (mean scores ≥3.5 indicating positive or high levels). Descriptive statistics, chi-square tests, multivariable logistic regression, sensitivity analyses, and polypharmacy subgroup analyses were performed to identify factors associated with favorable acceptance. RESULTS: Among 552 participants (mean age 52.7 ± 12.6 years; 56.3% female), the most prevalent chronic diseases were hypertension (213, 38.6%) and diabetes mellitus (179, 32.4%), with 154 (27.9%) reporting polypharmacy (≥5 medications). 59.2% demonstrated good knowledge (mean score 5.3 ± 1.8). Moderately positive attitudes were observed in 48.6% (mean 3.6 ± 0.9), while 52.7% reported high perceptions (mean 3.7 ± 0.9). Strong support was reported for AI-based reminders (80%) and educational functions (76%), whereas endorsement of predictive features was lower (49-58%). Major concerns included privacy (71%), technical reliability, and reduced human interaction. Chi-square tests showed significant associations with age and digital literacy (p < 0.001). Multivariable logistic regression confirmed that younger age, higher education, advanced digital literacy, and smartphone ownership independently predicted favorable KAP (p < 0.001). Polypharmacy was associated with greater receptivity in unadjusted analyses but was not an independent predictor after adjustment. Findings remained robust in sensitivity analyses. CONCLUSION: Jordanian patients with chronic diseases show moderate-to-good knowledge and cautiously positive attitudes toward AI-enabled medication adherence tools. Acceptance is shaped mainly by digital literacy and trust, underscoring the need for governance frameworks, clinician oversight, Arabic-language design, and targeted digital literacy initiatives to support equitable integration into national platforms such as Hakeem.
Adherence to Electronic Patient-Reported Outcome Measures: A Null-Results Review of Measure-Related Effects on Response Rates in Routine Care.
Mukowski-Kickhöfel R, Otto LR, Rogge AA
Patient Prefer Adherence · 2026 · PMID 41937938 · Full text
This systematic review focuses on measure-related effects of PROMs on patient acceptance, adherence, and response rates in routine clinical care. The review received no external funding and was registered on medRxiv [med...
This systematic review focuses on measure-related effects of PROMs on patient acceptance, adherence, and response rates in routine clinical care. The review received no external funding and was registered on medRxiv [medRxiv 2024.06.13.24308883] prior to its execution. It was conducted in accordance with PRISMA guidelines. Studies in English or German from the past ten years including patients ≥18 years in routine care with multiple measurement time points were included. Reports on clinical trials in terms of drug or intervention research as well as study protocols were excluded. A literature search across MEDLINE, Embase [Ovid], CINAHL, PsychArticles, PsycInfo [Ebsco], Scopus and Web of Science identified n = 420 potentially relevant publications. The data were retrieved from the data banks on 31st of January 2024. In the full-text screening, no study met the predefined inclusion criteria, therefore no risk of bias assessment or result synthesis was performed. This unexpected finding underscores a significant research gap. It indicates that the effects of instrument-inherent properties (like structure or wording) on patient adherence to PRO assessments have not been evaluated in routine care settings. The design of PROMs can have a potential influence on patient participation and the resulting data quality, which is especially relevant in light of the rising use of PRO assessments in routine care and the growing interest in real-world evidence data. Due to its search window of 10 years, its restriction to articles published in English or German, and its focus on routine care settings, the review may have excluded qualitative research and early works on adherence in routine care. Overall our review highlights the need for future research focusing on intrinsic PROM characteristics and how they relate to patients' acceptance and adherence in order to explore the full potential of real-world data.
The Effect of Changes in Defecation Posture on Health-Related Quality of Life Among Elderly Habitual Squat-Toilet Users After Total Hip Arthroplasty for Femoral Neck Fracture.
Zhao Y, Guo D, Yan C … +3 more , Dong Y, Li X, Zhang J
Patient Prefer Adherence · 2026 · PMID 41926494 · Full text
BACKGROUND: Elderly patients undergoing total hip arthroplasty (THA) for femoral neck fractures are commonly restricted from squatting postoperatively. In regions where squat toilets are widely used, older adults who are...
BACKGROUND: Elderly patients undergoing total hip arthroplasty (THA) for femoral neck fractures are commonly restricted from squatting postoperatively. In regions where squat toilets are widely used, older adults who are accustomed to squatting may be forced to transition to a sitting defecation posture, which can affect daily functioning and health-related quality of life (HRQoL), yet this culturally specific clinical issue remains insufficiently studied. METHODS: A total of 152 elderly patients with displaced intracapsular femoral neck fractures underwent primary cementless THA between January 2023 and July 2024. Defecation posture was evaluated using the 10-item Toilet Posture Score (TPS) preoperatively and at 1, 3, and 6 months after surgery. HRQoL was assessed with the EQ-5D-5L and EQ-VAS. Changes in TPS were examined across time points using repeated-measures ANOVA. Multivariable linear regression models were constructed to determine whether 6-month TPS improvement predicted 6-month HRQoL gains after adjustment for age, sex, body mass index, and Charlson Comorbidity Index. RESULTS: The mean age was 77.82 ± 7.11 years, and 72.4% were women. TPS decreased from 16.02 ± 2.37 preoperatively to 15.38 ± 2.61 at 1 month (P = 0.004), and further improved to 12.68 ± 2.49 and 11.22 ± 2.70 at 3 and 6 months (both P < 0.001). EQ-5D-5L increased from 0.61 ± 0.15 preoperatively to 0.82 ± 0.13 at 6 months (P < 0.001), and EQ-VAS increased from 55.10 ± 11.90 to 78.38 ± 12.31 (P < 0.001). Greater improvement in defecation posture independently predicted larger improvements in both EQ-5D-5L (B = -0.037; 95% CI -0.043 to -0.032; P < 0.001) and EQ-VAS (B = -1.319; 95% CI -1.386 to -1.252; P < 0.001) change scores at 6 months. Constipation requiring medical advice occurred in 36 patients (23.7%). CONCLUSION: Elderly patients who are accustomed to squatting experience considerable restrictions in defecation posture after THA. The degree of postural improvement independently predicts HRQoL gains assessed by both EQ-5D-5L and EQ-VAS. Post-THA rehabilitation should include targeted toileting education and gradual posture retraining to facilitate a safe transition from squat toilets to sitting toilets while maintaining hip precautions.
Sleep Quality and Its Relationship with Temporomandibular Disorders and Oral Health-Related Quality of Life Among Dental Students and Interns: A Cross-Sectional Study.
Alsubaie N, Alshahrani W, Alabdulkarim SS … +4 more , Alghannam RJ, Shahin S, Alamri A, Nazir MA
Patient Prefer Adherence · 2026 · PMID 41924319 · Full text
PURPOSE: This cross-sectional study aimed to evaluate sleep quality and its relationship with temporomandibular disorders and oral health-related quality of life among dental students and interns. PATIENTS AND METHODS: T...
PURPOSE: This cross-sectional study aimed to evaluate sleep quality and its relationship with temporomandibular disorders and oral health-related quality of life among dental students and interns. PATIENTS AND METHODS: This study was conducted on dental students and interns at Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Undergraduate male and female dental students and interns voluntarily participated in the study. The participants completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, Fonseca's questionnaire for temporomandibular disorders (TMD), and the Oral Health Impact Profile (OHIP) for oral health-related quality of life (OHRQoL) in addition to demographic data. Pearson's correlation test and multiple linear regression analysis were performed in the study. RESULTS: The study included 159 participants, with 42.8% males and 57.2% females. Most participants (89.3%) demonstrated poor sleep quality. More than half of the study sample (57.2%) had TMD, with 29.6% having mild TMD, 23.3% having moderate TMD, and 4.4% having severe TMD. Bivariate analysis showed that sleep quality was significantly correlated with TMD (r=0.211, P=0.008) and OHRQoL (r=0.200, P=0.012). In addition, TMD were significantly correlated with OHRQoL (r=0.443, P<0.001). According to multiple linear regression analysis models, sleep quality was significantly correlated with TMD (P= 0.029) and OHRQoL (P=0.016) after controlling for age, gender, class year, educational levels of parents, and monthly family income. Similarly, regression analysis showed that TMD was significantly correlated with OHRQoL (P<0.001). Mediation analysis showed a significant indirect effect of sleep quality on OHRQoL through TMD (effect = 0.31, 95% CI=0.09, 0.56). CONCLUSION: The study showed that poor sleep quality was very common among dental students and interns. Sleep quality was significantly correlated with TMD and OHRQoL, and TMD significantly impacted OHRQoL.
Assessment of Adherence to Medication and Its Association with Health-Related Quality of Life Among Hypertensive Patients in the United Arab Emirates.
Maqadmi AF, Ghannem K, Sebastian J
Patient Prefer Adherence · 2026 · PMID 41924318 · Full text
BACKGROUND: Many patients, especially those with chronic conditions (eg, hypertension, cardiovascular disease), struggle to adhere to long-term medication regimens, leading to serious complications and reduced quality of...
BACKGROUND: Many patients, especially those with chronic conditions (eg, hypertension, cardiovascular disease), struggle to adhere to long-term medication regimens, leading to serious complications and reduced quality of life. METHODS: A cross-sectional study at Thumbay University Hospital was conducted among hypertensive patients (≥18 years, ≥6 months on antihypertensive therapy) to assess medication adherence and its association with health-related quality of life (HRQoL). Data were collected using a structured questionnaire; adherence and HRQoL were measured by the Hill-Bone and WHOQOL-BREF instruments; data were analyzed with descriptive statistics, chi-square tests, binary logistic regression, and Spearman correlations. RESULTS: Among 377 patients medication adherence was predominantly high in 55.7% of patients, medium in 40.6%, and low in 3.7%; 76.9% reported high HRQoL, with the highest domain score in Environment (81.25%) and lowest in Physical health (67.86%) (differences were significant). Spearman correlations showed small but significant associations between adherence and Physical ( = -0.10, p = 0.05) and Environment ( = 0.12, p = 0.02); other domains were non-significant. Longer hypertension duration increased adherence (AOR 6.98 for 10-<15 years, p < 0.001; 8.81 for ≥15 years, p = 0.01), whereas non-Muslim religion (AOR 0.49, p = 0.03) and no family history (AOR 0.57, p = 0.04) predicted lower adherence. In multivariate HRQoL analysis, age ≥60, home ownership, comorbidity, and ≥3 antihypertensives had AORs of 0.40, 0.34, 0.22, and 0.10 (p = 0.03, 0.01, 0.03, 0.00) for lower HRQoL; regular income and no alternative medicine had AORs of 2.67 and 2.60 (p = 0.03, 0.01) for higher HRQoL. CONCLUSION: Adherent in this UAE study was high (55.7%), and HRQoL was generally favorable; HRQoL was higher with regular income, home ownership, and no alternative medicine, but lower with comorbidities, age ≥60, and ≥3 antihypertensives. Adherence improved with longer disease duration and was influenced by religion and family history, highlighting the need for targeted interventions to improve adherence and HRQoL.
The Paradox of Education and the Failure of Communication: A Cross-Sectional Study of Topical Corticosteroid Phobia and Its Impact on Treatment Adherence Among Urban Primary Care Patients in Shenzhen, China.
Huang J, Chen W, Ma L … +4 more , Wen Z, Shi M, Hong F, Hou S
Patient Prefer Adherence · 2026 · PMID 41918514 · Full text
BACKGROUND: Topical corticosteroid (TCS) phobia is increasingly recognized as a barrier to treatment adherence in dermatology. However, evidence from community-based primary care settings in urban China remains limited....
BACKGROUND: Topical corticosteroid (TCS) phobia is increasingly recognized as a barrier to treatment adherence in dermatology. However, evidence from community-based primary care settings in urban China remains limited. Understanding patient perceptions in these settings is essential for improving adherence and promoting shared decision-making. PURPOSE: To investigate the prevalence of TCS phobia among urban primary care patients in Shenzhen, identify associated factors, and evaluate its influence on treatment preferences and adherence behaviors. PATIENTS AND METHODS: A cross-sectional survey was conducted among community residents attending urban primary care clinics using an anonymous electronic questionnaire. Of the 300 eligible patients approached, 199 provided valid responses, yielding a response rate of 66.3%. An anonymous electronic questionnaire captured demographic data, TCS knowledge, attitudes, information sources, and treatment behaviors. Associations with TCS phobia were assessed using Chi-square tests. RESULTS: TCS phobia was reported by 26.1% of participants. Higher educational attainment was significantly associated with greater phobia ( = 0.021), demonstrating an "education paradox." Misconceptions related to systemic adverse effects-especially weight gain ( < 0.001) and organ damage ( = 0.009)-were the strongest contributors to phobia. Concerns about local side effects did not differ significantly between groups. TCS phobia was strongly associated with refusal of prescribed therapy and preference for "natural" products (both < 0.001). Knowledge of appropriate TCS use and information sources (physicians or media) did not significantly influence phobia levels. CONCLUSION: TCS phobia is common among educated urban primary care patients and is driven primarily by incorrect beliefs about systemic toxicity. These fears have direct, negative consequences on treatment adherence. Current communication strategies appear insufficient. Patient-centered counseling that directly addresses misconceptions and emphasizes the distinction between topical and systemic corticosteroids is urgently needed in primary care practice.
A Qualitative Patient Journey Map of the Ophthalmic Day-Surgery Experience.
Feng D, Wang Y, Yin S … +2 more , Chen Y, Zhang D
Patient Prefer Adherence · 2026 · PMID 41918513 · Full text
OBJECTIVE: To identify the multidimensional health management needs of ophthalmic day surgery patients, and explore their preferences, adherence behaviors and self-management challenges throughout the care continuum via...
OBJECTIVE: To identify the multidimensional health management needs of ophthalmic day surgery patients, and explore their preferences, adherence behaviors and self-management challenges throughout the care continuum via patient journey mapping, thereby providing targeted insights for optimizing clinical workflows, care services and enhancing care continuity. METHODS: A descriptive qualitative study was conducted from September to November 2024. Semi-structured in-depth interviews were carried out with 22 ophthalmic day-surgery patients and 10 healthcare providers at a tertiary hospital in Hubei Province, China. Collected data were systematically analyzed using content analysis to construct a comprehensive patient journey map for ophthalmic day surgery. RESULTS: The ophthalmic day surgery patient journey was segmented into five sequential phases along the treatment timeline: diagnosis, preoperative preparation, surgical intervention, postoperative recovery, and post-discharge monitoring. A total of 49 themes were identified across four core dimensions (health management tasks, emotional experiences, clinical pain points, and service improvement opportunities), with key findings including prominent age-related disparities in care experience, persistent preoperative anxiety among patients, insufficient adherence to medication and follow-up protocols, and critical gaps in post-discharge care continuity. Collectively, these themes formed a visualized patient journey map that fully reflects patients' dynamic preferences and self-management barriers across the entire care process. CONCLUSION: The health management needs of ophthalmic day surgery patients are dynamic and multidimensionally interrelated across the whole treatment journey, with poor care continuity, weak multidisciplinary collaboration, and low adherence to self-management behaviors being the core clinical challenges. The constructed patient journey map reveals that optimizing age-friendly service design and establishing a continuous care system are the primary service implications for improving patient experience; targeted interventions addressing the above challenges can effectively enhance patients' treatment adherence and self-management capabilities, and further promote the high-quality development of ophthalmic day surgery services with a patient-centered approach.
Evolving Medication Adherence in the Early Post-Kidney Transplant Period: Recipients' Lived Experiences from a Single-Center Qualitative Study in Taiwan.
Huang YJ, Huang YM, Chen CC … +2 more , Lin SY, Kuan CI
Patient Prefer Adherence · 2026 · PMID 41913731 · Full text
BACKGROUND: Medication non-adherence remains a common challenge among kidney transplantation recipients and is associated with graft dysfunction and loss. Although numerous interventions have been proposed, medication-ta...
BACKGROUND: Medication non-adherence remains a common challenge among kidney transplantation recipients and is associated with graft dysfunction and loss. Although numerous interventions have been proposed, medication-taking is increasingly recognized as a dynamic process shaped by patients' daily experiences and changing perceptions after transplantation. This study explored how kidney transplant recipients experience and manage immunosuppressive medication adherence over time and identified factors that influence adherence behaviors during recovery. METHODS: This qualitative study used a phenomenology-informed thematic analysis to explore kidney transplant recipients' lived experiences of immunosuppressive medication adherence. Semi-structured face-to-face interviews were conducted with kidney transplant recipients at a medical center in Taiwan between March and July 2022. A dual-sampling strategy recruited participants in the early post-transplant period and recipients more than one-year post-transplant who had experienced adherence challenges. Participants were followed longitudinally beginning shortly after hospital discharge. Contextual information from a mobile communication application used for clinical follow-up was incorporated to support interpretation of adherence-related experiences. Interviews were audio-recorded, transcribed verbatim, and analyzed using data-driven thematic analysis with NVivo software. Reflexive and collaborative coding processes were applied to enhance analytical rigor. RESULTS: Twelve kidney transplant recipients participated in the study. Six themes described the evolving nature of medication adherence. Improved well-being after transplantation reinforced motivation to adhere, as recipients linked medication-taking with maintaining restored health and independence. However, persistent but mild side effects sometimes created uncertainty about treatment. Over time, vigilance toward medication-taking declined as perceived risk of graft rejection decreased. Daily routines and personal beliefs about medications also shaped adherence behaviors. Mobile-based consultation with healthcare professionals provided timely guidance and reassurance. CONCLUSION: Medication adherence after kidney transplantation is dynamic and influenced by perceptions of health improvement, treatment burden, and evolving beliefs about medication necessity. Phase-specific and patient-centered strategies, including tailored education and accessible consultation support, may help sustain long-term adherence and optimize graft outcomes.
Learning Needs in Heart Failure Care Across Patients, Caregivers, and Healthcare Professionals: A Scoping Review of Asian Studies.
Sugiharto F, Trisyani Y, Nuraeni A … +1 more , Abdullah KL
Patient Prefer Adherence · 2026 · PMID 41907156 · Full text
BACKGROUND: Heart failure (HF) is a significant and growing public health challenge in Asia. Effective HF management relies heavily on sustained self-care and education involving not only patients but also family caregiv...
BACKGROUND: Heart failure (HF) is a significant and growing public health challenge in Asia. Effective HF management relies heavily on sustained self-care and education involving not only patients but also family caregivers and healthcare professionals. However, no previous review has systematically mapped the multidimensional learning needs of patients, family caregivers, and healthcare professionals in this region. PURPOSE: This scoping review aimed to identify, categorize, and synthesize existing evidence on learning needs in HF care from the perspectives of patients, caregivers, and healthcare professionals across Asian populations. METHODS: Using the Arksey and O'Malley framework and reported in accordance with PRISMA guidelines, four databases (PubMed, Scopus, EBSCOhost, and Taylor & Francis) and the Google Scholar search engine were searched for Asian studies on August 19, 2025. Sixteen eligible studies published between 2010 and 2025 were included. Data were charted and analysed thematically to identify patterns and variations across three stakeholder perspectives. RESULTS: A total of 16 studies were included in this review. The thematic analysis identified three perspectives of learning needs. From the patients' perspective, the key priorities were disease knowledge, medication management, symptom recognition, lifestyle modification, and psychosocial adaptation. Caregivers' perspective emphasised practical caregiving skills, emotional resilience, and access to guidance and social support. Meanwhile, the healthcare professionals' perspective highlighted patient-centred communication, consistent educational delivery, and interprofessional coordination. CONCLUSION: This review demonstrates a clear need for an integrated and culturally responsive educational framework that aligns the learning priorities of patients, caregivers, and healthcare professionals. Educational interventions should address both clinical and psychosocial dimensions of HF care. Nurses play a crucial role as key educators within multidisciplinary teams and should be empowered to facilitate coherent, continuous, and patient-centered learning across care settings.
Decision-Making Dilemmas Among Elderly Prostate Cancer Patients Receiving Lu-PSMA Therapy: A Qualitative Study.
Chen Y, Liu C, Li R … +2 more , He Y, Li L
Patient Prefer Adherence · 2026 · PMID 41907155 · Full text
OBJECTIVE: To explore the decision-making dilemmas experienced by elderly patients with advanced prostate cancer when considering Lu-PSMA therapy, and to provide evidence for the development of tailored decision-support...
OBJECTIVE: To explore the decision-making dilemmas experienced by elderly patients with advanced prostate cancer when considering Lu-PSMA therapy, and to provide evidence for the development of tailored decision-support strategies. METHODS: A qualitative descriptive design was adopted. Using purposive sampling, 20 elderly prostate cancer patients who had received Lu-PSMA therapy at a tertiary hospital in China between April and June 2025 were recruited for semi-structured interviews. Data were analyzed following Braun's style of thematic analysis. RESULTS: Three overarching themes and nine subthemes were identified, reflecting multi-layered decision-making conflicts. (1) Decision-making triggers dilemma described information cognitive deficits, family value conflicts, and weak support systems that constrained patients' understanding and autonomy. (2) Decision-conflicting perceptual dilemma captured uncertainty regarding treatment efficacy and emotional distress caused by disease progression and prior treatment experiences. (3) Coping-adaptive behavioral dilemma illustrated financial constraints, dependent decision tendencies, and varied coping strategies, alongside expressed needs for accessible and technology-supported tools. These findings reveal the complex interplay of cognitive, emotional, familial, and systemic factors influencing treatment decisions. CONCLUSION: Effective resource support can help elderly prostate cancer patients cope with various dilemmas during the Lu-PSMA treatment decision-making process. Nursing staff should address the actual needs of patients, explore the clinical application of emerging age-appropriate decision-support interventions, and construct decision-support programs tailored to patient characteristics, thereby helping patients develop positive coping mechanisms and enhancing their active participation as well as rational decision-making abilities.
Application of Positional Nursing Combined with Positive Suggestion in Patients Undergoing Sedated Gastroscopy.
Mu L, Wang Y, Duan J
Patient Prefer Adherence · 2026 · PMID 41907154 · Full text
PURPOSE: To investigate the effects of positional nursing combined with positive suggestions on anxiety, procedural outcomes, and patient comfort in patients undergoing painless gastroscopy. PATIENTS AND METHODS: This re...
PURPOSE: To investigate the effects of positional nursing combined with positive suggestions on anxiety, procedural outcomes, and patient comfort in patients undergoing painless gastroscopy. PATIENTS AND METHODS: This retrospective cohort study enrolled 153 patients undergoing sedated gastroscopy between March 2024 and August 2025. Patients were assigned to the conventional nursing group (n=73, March-October 2024) or the comprehensive nursing group (n=80, November 2024-August 2025). The comprehensive group received individualized positioning optimization and standardized positive psychological suggestions. Primary outcomes included State-Trait Anxiety Inventory-State subscale (STAI-S), examination success rate, examination duration, and General Comfort Questionnaire (GCQ). Secondary outcomes included hemodynamic stability, adverse events, recovery time, and patient satisfaction. RESULTS: Baseline characteristics were comparable between groups. The comprehensive nursing group demonstrated significantly lower STAI-S scores (43.23±7.68 vs 48.67±8.45, <0.001) and shorter examination duration (6.54±1.62 min vs 7.23±1.87 min, =0.016). GCQ scores were significantly higher in the comprehensive group ( <0.001). The comprehensive group maintained better intra-procedural hemodynamic stability with lower heart rates ( =0.002), higher oxygen saturation ( <0.001), and higher blood pressure levels (systolic BP: =0.020; diastolic BP: =0.008). Comprehensive group had lower overall adverse event incidence, shorter recovery time and higher modified Patient Satisfaction Questionnaire scores (modified PSQ-18) (all <0.05). CONCLUSION: Positional nursing combined with positive suggestion may help reduce pre-procedural anxiety, improve hemodynamic stability, decrease adverse events, and enhance patient comfort and satisfaction in painless gastroscopy. This non-pharmacological intervention shows promise for integration into routine endoscopy nursing protocols.
Eighteen Years of Measuring Treatment Satisfaction in Clinical Research: A Scoping Review of Instruments and Contexts of Use.
Navas C, Valiente-Alandi I, Luque-Aguilera L … +1 more , Rodriguez-Leboeuf AM
Patient Prefer Adherence · 2026 · PMID 41907153 · Full text
PURPOSE: Despite the widespread use of Patient Reported Outcomes (PRO) instruments to assess treatment satisfaction in clinical trials and academic research, a comprehensive review mapping these tools across therapeutic...
PURPOSE: Despite the widespread use of Patient Reported Outcomes (PRO) instruments to assess treatment satisfaction in clinical trials and academic research, a comprehensive review mapping these tools across therapeutic areas has been lacking. This scoping review addresses this gap by examining the application of PRO instruments over the past 18 years. METHODS: Following Arksey and O'Malley's framework and mixed-method principles, we searched Ovid MEDLINE and Ovid EMBASE from 2004 to June 2022. Data extraction was structured according to review objectives and key domains. RESULTS: Of 3,497 articles retrieved, 1,398 studies reported using PRO instruments for treatment satisfaction. The most common therapeutic areas were endocrine, nutrition, and metabolic disorders, followed by mental and behavioral conditions. Most studies were conducted in academic settings (53.1%) or Phase III clinical trials (27.5%). The Treatment Satisfaction Questionnaire for Medication (TSQM) was the most frequently used generic instrument, while the Diabetes Treatment Satisfaction Questionnaire (DTSQ) was the leading disease-specific tool. Many instruments lacked psychometric validation, limiting comparability. CONCLUSION: PRO instruments for treatment satisfaction are primarily used in chronic disease contexts. Their widespread adoption underscores the need for validated tools to ensure robust, comparable data and support better patient outcomes.
Latent Profile Analysis of Disease Self-Management and Its Associated Factors Among People Living with HIV with Dyslipidemia.
Yin S, Yuan Y, Wang H … +2 more , Hu A, Zhang K
Patient Prefer Adherence · 2026 · PMID 41907152 · Full text
PURPOSE: To identify latent self-management profiles in people living with HIV (PLWH) with dyslipidemia and factors associated with profile membership, thereby facilitating targeted clinical intervention. METHODS: A cros...
PURPOSE: To identify latent self-management profiles in people living with HIV (PLWH) with dyslipidemia and factors associated with profile membership, thereby facilitating targeted clinical intervention. METHODS: A cross-sectional survey was conducted from December 2024 to June 2025 among 333 PLWH with dyslipidemia at Nanjing Second Hospital. Data were collected via sociodemographic/disease-related questionnaire, the HIV Self-Management Scale (HIVSMS), and the Health Literacy Management Scale (HLMS). Latent profile analysis (LPA) was performed in Mplus 8.3, and multinomial logistic regression was used to examine factors associated with profile membership. RESULTS: Fit indices (entropy = 0.993) supported a three-profile solution: low self-management-low social support-seeking (C1, 42.3%), moderate self-management-stable (C2, 37.8%), and high self-management-emotion regulation dominant (C3, 19.8%). Seeking social support was relatively low across profiles. Compared with C1, C2 membership was significantly associated with higher education and income, lipid-lowering medication use (OR 3.735, 95% CI 1.597-8.736), and CD4 350-500 cells/μL, and was less likely among participants with VL >1000 copies/mL or chronic comorbidities (all P < 0.05). Compared with C1, C3 membership was significantly associated with HIV infection duration ≥5 years, higher education and income, CD4 >500 cells/μL, and higher HDL-C, and was less likely among those with VL >1000 copies/mL (OR 0.037, 95% CI 0.004-0.380) or chronic comorbidities (all P < 0.05). Compared with C2, C3 membership was independently associated with higher health literacy (HL) (OR 1.038 per point, 95% CI 1.012-1.064) and was less likely among those with LDL-C ≥3 mmol/L (P < 0.05). CONCLUSION: We identified three distinct self-management profiles among PLWH with dyslipidemia. Profile membership was significantly associated with HL and socioeconomic, HIV-related, lipid-related, and comorbidity factors, supporting the need for profile-tailored strategies to improve self-management.
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