Cecelia I Nelson, Destiny Noel, Line Caes, Klanci M McCabe, Christina L Duncan
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引用次数: 0
Abstract
Objective: Juvenile idiopathic arthritis (JIA) is one of the leading causes of chronic pain in pediatric patients. Treatment regimens, which are critical to symptom management, can be burdensome, involving medication with potentially aversive side effects and exercise that can cause joint pain. Thus, it is important to examine the barriers and facilitators to adherence in JIA. While systematic reviews exist for rheumatic disease in adults, there has not yet been a synthesis of the literature examining adherence in JIA.
Methods: PsychINFO, PubMed and MEDLINE databases were systematically searched to identify qualitative and quantitative empirical studies that investigate adherence for JIA. Keywords included: patient compliance OR adherence OR persistence; youth OR children OR juvenile OR pediatric OR teen OR child OR adolescent; and rheumatoid arthritis OR idiopathic arthritis OR arthritis. Articles were excluded from the review if they involved non-human or adult samples, were non-experimental (e.g., practice recommendations), were not peer-reviewed, or were not written in English. After abstract selection, 32 articles were included in the analyses.
Results: Adherence to exercise regimens was consistently lower than adherence to medication. Researchers relied heavily on self-report of adherence, which suggests a need for additional research with more objective measures of adherence. Across studies, psychological treatment was not included, so adherence to this treatment component in JIA remains understudied.
Conclusions: Results suggest that future research should target devising and evaluating interventions to improve adherence to exercise and perhaps psychological treatment.
Implications for impact: To facilitate adherence in JIA, behavioral health providers should focus on building a strong therapeutic alliance between provider and child, fostering positive coping skills in parents and children, and monitoring the parent-child relationship.
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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