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Title: Psychological factors associated with episodic chelation adherence in thalassaemia
Author: Vosper, Jane
ISNI:       0000 0004 2749 6245
Awarding Body: University of London
Current Institution: University of London
Date of Award: 2012
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Beta-Thalassaemia-Major is a life-long genetic haemoglobin disorder where patients require intensive treatment regimens to stay alive, including frequent blood transfusions and daily chelation therapy. Adherence to chelation therapy is vitally important to prevent organ damage and potential death. Little research has been conducted into the psychosocial correlates of chelation adherence representing a significant gap in the literature. Information concerning psychosocial factors is important when considering potential interventions to improve adherence and improve health outcomes. The present study aimed to address this gap in the literature by investigating correlates of chelation adherence on a daily (episodic) basis as well as on a generic (global) basis. Using constructs suggested by the Health Action Process Approach, the study hypotheses were that situational self-efficacy and positive outcome expectancies would differentiate episodes of adherence and non-adherence. A secondary hypothesis was that lower levels of depression and perceptions of severe illness consequences would be associated with higher global adherence. Thirty-seven participants with Beta-Thalassaemia Major were recruited for the study, 31 of whom completed the episodic part of the study and all who completed the global parts of the study. A structured interview was used to obtain accounts of adherent and non-adherent episodes including behavioural situational variables as well as psychological situational variables (e.g. self-efficacy, mood and outcome expectancies). Validated questionnaires were used to assess depression, anxiety and illness perceptions and their relationship with adherence. Bivariate analyses revealed that a number of behavioural situational variables were associated with adherence episodes as well as ratings of self-efficacy and outcome expectancies. Conditional logistic regression analysis revealed that positive outcome expectancies and higher self-efficacy together Significantly predicted adherent episodes, however, only self-efficacy independently predicted adherent episodes. No associations between global adherence and depression, anxiety and illness perceptions were found. The findings are discussed in relation to general adherence literature as well as to chelation adherence specifically. Theoretical and practice implications are explored.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available