| 1. |
- Axelsson, Malin, 1964-, et al.
(författare)
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A personality and gender perspective on adherence and health-related quality of life in people with asthma and/or allergic rhinitis.
- 2014
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Ingår i: Journal of the American Association of Nurse Practitioners. - : Ovid Technologies (Wolters Kluwer Health). - 2327-6886 .- 2327-6924. ; 26:1, s. 32-39
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Poor adherence to medication treatment for asthma and allergic rhinitis could challenge a positive health outcome. Health-related quality of life (HRQL) is an important measure of health outcome. Both personality and gender could influence adherence and perceptions of HRQL. The purpose was to clarify the role of personality and gender in relation to adherence and HRQL in people with asthma and/or rhinitis.DATA SOURCES: Participants (n = 180) with asthma and allergic rhinitis, selected from a population-based study, filled out questionnaires on the five-factor model personality traits-neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness-HRQL, and adherence to medication treatment. Data were statistically analyzed using t-tests, Mann-Whitney tests, bivariate correlations, and multiple regressions.CONCLUSIONS: Personality traits were associated with adherence to medication treatment in men. The influence of personality traits on HRQL also differed between men and women. These differences suggest that both a personality and gender perspective should be considered when planning care support aimed at improving adherence and HRQL in people living with asthma and/or allergic rhinitis.IMPLICATIONS FOR PRACTICE: It is suggested that both a personality and gender perspective be taken into account in care support aimed at improving adherence and HRQL in people with asthma and allergic rhinitis.
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| 2. |
- Axelsson, Malin, 1964-, et al.
(författare)
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Motivational foci and asthma medication tactics directed towards a functional day
- 2011
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 11, s. 809-
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Tidskriftsartikel (refereegranskat)abstract
- Background:There appears to be an obvious gap between a medical and patient adherence perspective.Deviating from a medication prescription could be regarded as fairly irrational, but with respect to patients' goals and/or concerns it could be seen as understandable. Thus, the aim was to elucidate adherence reasoning in relation to asthma medication.Methods:This was a qualitative study; data collection and analysis procedures were conducted according to Grounded Theory methodology. Eighteen persons, aged 22 with asthma and regular asthma medication treatment, were interviewed.Results:The emerged theoretical model illustrated that adherence to asthma medication was motivated by three foci, all directed towards a desired outcome in terms of a functional day as desired by the patient. Apromotive focus was associated with the ambition to achieve a positive asthma outcome by being adherent either to the received prescription or to a self-adjusted dosage. A preventive focuswas intended to ensure avoidance of a negative asthma outcome either by sticking to the prescription or by preventively overusing the medication. A permissive focus was associated with unstructured adherence behaviour in which medication intake was primarily triggered by asthma symptoms.Conclusions:As all participants had consciously adopted functioning medication tactics that directed themtowards the desired goal of a functional day. In an effort to bridge the gap between a patient- and a medical adherence perspective, patients need support in defining their desired functionality and guidance in developing a person-based medication tactic.
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| 3. |
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| 4. |
- Axelsson, Malin, 1964
(författare)
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Personality and adherence to medication treatment
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Striving for improved adherence to medication treatment is of vital concern, as low adherence is a major obstacle in treating many prevalent chronic diseases. Several factors have been identified that seem to influence adherence behaviour, but limited research exists on the significance of personality for adherence to medication treatment. According to the Five-Factor Model (FFM), personality can be described in terms of five broad personality traits: Neuroticism, Extraversion, and Openness to experience, Agreeableness, and Conscientiousness. Reports on health-related quality of life (HRQL), asthma control and selfefficacy may also be influenced by personality. Therefore, the overall aim of the present research project was to explore the significance of personality traits in relation to adherence to medication treatment and asthma control, health-related quality of life and self-efficacy.
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| 5. |
- Axelsson, Malin, 1964-
(författare)
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Personality and reasons for not using asthma medication in young adults
- 2013
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 42:4, s. 241-246
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To identify young adults' stated reasons for not taking asthma medication and to determine the significance of personality, asthma control and health-related quality of life in relation to these stated reasons. Background: Reasons for non-adherence to asthma medication treatment have previously been studied, but research on the significance of personality in relation to stated reasons for not taking asthma medication is limited. Methods: Young adults with asthma (age 22years; n=216) stated their most common reasons for not taking asthma medication and completed postal questionnaires on personality, asthma control and health-related quality of life (HRQL). Results: The most common reason for non-adherence was ". No perceived need" (n=141). Participants giving this reason for not taking asthma medication scored lower on the personality trait Negative Affectivity and reported both higher asthma control and higher mental HRQL. "Insufficient routines" was the second most common reason (n=66), and participants stating it scored higher on Negative Affectivity and reported lower asthma control. An increase in asthma control increased the odds of stating ". No perceived need" as the reason for not taking asthma medication. An increase in Negative Affectivity was associated with an increase in the odds of giving ". Insufficient routines" as a reason. Conclusions: The personality trait Negative Affectivity and perceived asthma control played a role in the young adults' stated reasons for not taking asthma medication, which indicates that these parameters are of importance to young adults' medication management. © 2013 Elsevier Inc.
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| 6. |
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| 7. |
- Axelsson, Malin, 1964-, et al.
(författare)
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Recent educational interventions for improvement of asthma medication adherence.
- 2012
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Ingår i: Asia Pacific allergy. - Korea : Asia Pacific Association of Allergy, Asthma and Clinical Immunology. - 2233-8276 .- 2233-8268. ; 2:1, s. 67-75
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Tidskriftsartikel (refereegranskat)abstract
- Poor adherence to asthma medication treatment is a dilemma as it decreases the chance of achieving and maintaining a proper asthma control. Another dilemma is that there seems to be a small range of functional interventions that enhance adherence to long-term medication treatments. The aim was to review the last five years of published educational interventions for improving adherence to asthma medication. Through systematic database searches 20 articles were identified, which matched the inclusion criteria and described educational interventions to improve asthma self-management including adherence. The current review showed that addressing unintentional non-adherence in terms of incorrect inhaler technique by recurrent education improved the technique among many patients, but not among all. Phoning patients, as a means to remove medication beliefs as adherence barriers, seemed to be an effective educational strategy, shown as increased adherence. Involving patients in treatment decisions and individualising or tailoring educational support also seemed to have favourable effect on adherence. To conclude, addressing specific adherence barriers such as poor inhaler technique or medication beliefs could favour adherence. To change adherence behavior, the current review proposes that educational adherence support should be a collaborative effort between the patient and the health-care professional based on each individual patient's needs and patient factors, including elements such as personality traits.
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| 8. |
- Axelsson, Malin, 1964-
(författare)
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Report on personality and adherence to antibiotic therapy : a population-based study
- 2013
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Ingår i: BMC Psychology. - : Springer Science and Business Media LLC. - 2050-7283. ; 1:1, s. 24-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Antimicrobial resistance results from inappropriate use of antibiotics and makes common or life-threatening infections more difficult or sometimes impossible to treat. Proper adherence to antibiotic therapy is one among several measures required to prevent antimicrobial resistance. Knowledge of personality traits could help in identifying patients who need support with their adherence behaviour. Previous research has presented associations between personality traits and adherence to long-term medication treatment in individuals with different chronic diseases. However, there is limited knowledge about associations between personality traits and adherence to both antibiotic therapy and to shorter treatment periods. The aim was to explore the relation between personality and adherence behaviour in people prescribed antibiotics for common infections.METHODS:In a population-based study, 445 respondents reported on their prescribed antibiotic therapy and completed the Neuroticism, Extraversion, and Openness to experience Five-factor Inventory and the Medication Adherence Report Scale. Data were statistically analysed using descriptive statistics, t-tests, bivariate correlations, multiple and logistic regressions.RESULTS:Non-adherence was estimated to be 9.4%. The most common reasons for stopping therapy prematurely was that the respondent was now healthy and that the respondents experienced side-effects. Non-adherent respondents scored lower on the personality traits Agreeableness and Conscientiousness. A logistic regression showed that higher scores on Agreeableness decreased the risk for non-adherence to antibiotic therapy. In a multiple regression, Neuroticism was identified as a negative predictor, and both Agreeableness and Conscientiousness were identified as positive predictors of adherence behaviour.CONCLUSIONS:Preventive measures to decrease non-adherence may be to inform patients not to interrupt the antibiotic therapy when they start to feel healthy and to inform them about how to prevent and handle common side-effects. As associations between personality and adherence mainly have been described in relation to long-term treatments in chronic diseases, the current study add to the literature by showing that personality traits also seem to be reflected in adherence to shorter treatment periods with antibiotics for common infections. More studies in this specific area of adherence research are recommended.
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| 9. |
- Axelsson, Malin, 1964, et al.
(författare)
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Self-efficacy and adherence as mediating factors between personality traits and health-related quality of life.
- 2013
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Ingår i: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. - : Springer Science and Business Media LLC. - 1573-2649 .- 0962-9343. ; 22:3, s. 567-575
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Personality traits are rather stable dispositions in adulthood, while self-efficacy and adherence may be modified through targeted interventions. Health-related quality of life (HRQL) serves as a vital outcome measure. The present aim was to explore the function of self-efficacy and adherence as mediators for the influencing effect of personality traits on HRQL in people with chronic disease. METHODS: An epidemiological sample of 786 persons completed questionnaires on personality, general self-efficacy, adherence behaviour and HRQL. Data were statistically analysed using descriptive statistics, correlation analyses and path models. RESULTS: Self-efficacy mediated the effect of Extraversion and Conscientiousness on mental HRQL. Neuroticism had a direct effect on both physical and mental HRQL. Adherence partially mediated the effect of both Agreeableness and Conscientiousness on mental HRQL. CONCLUSIONS: The mental HRQL in people scoring low on Extraversion or low on Conscientiousness could be improved by strengthening general self-efficacy. Increasing adherence in people scoring low on Agreeableness or Conscientiousness could improve their mental HRQL, but the improvement was small and may be of lesser clinical relevance. These results argue for personalized interventions intended to positively affect health outcomes in people with chronic disease.
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| 10. |
- Axelsson, Malin, 1964-, et al.
(författare)
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The function of medication beliefs as mediators between personality traits and adherence behavior in people with asthma
- 2013
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Ingår i: Patient Preference and Adherence. - 1177-889X. ; 7, s. 1101-1109
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Tidskriftsartikel (refereegranskat)abstract
- Background:There is evidence that both personality traits and personal beliefs about medications affect adherence behavior. However, limited research exists on how personality and beliefs about asthma medication interact in influencing adherence behavior in people with asthma. To extend our knowledge in this area of adherence research, we aimed to determine the mediating effects of beliefs about asthma medication between personality traits and adherence behavior.Methods:Asthmatics (n=516) selected from a population-based study called West Sweden Asthma Study completed the Neuroticism, Extraversion and Openness to Experience Five-Factor Inventory, the Medication Adherence Report Scale, and the Beliefs about Medicines Questionnaire. Data were analyzed using confirmatory factor analysis and structural equation modeling.Results:Three of the five investigated personality traits – agreeableness, conscientiousness, and neuroticism – were associated with both concerns about asthma medication and adherence behavior. Concerns functioned as a partial mediator for the influencing effects of agreeableness, conscientiousness, and neuroticism on adherence behavior.Conclusion:The findings suggest that personality traits could be used to identify individuals with asthma who need support with their adherence behavior. Additionally, targeting concerns about asthma medication in asthmatics with low levels of agreeableness or conscientiousness or high levels of neuroticism could have a favorable effect on their adherence behavior.
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| 11. |
- Axelsson, Malin, 1964, et al.
(författare)
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The function of medication beliefs as mediators between personality traits and adherence behavior in people with asthma
- 2013
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Ingår i: Patient Preference and Adherence. - : Informa UK Limited. - 1177-889X. ; 7, s. 1101-1109
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is evidence that both personality traits and personal beliefs about medications affect adherence behavior. However, limited research exists on how personality and beliefs about asthma medication interact in influencing adherence behavior in people with asthma. To extend our knowledge in this area of adherence research, we aimed to determine the mediating effects of beliefs about asthma medication between personality traits and adherence behavior. Methods: Asthmatics (n=516) selected from a population-based study called West Sweden Asthma Study completed the Neuroticism, Extraversion and Openness to Experience Five-Factor Inventory, the Medication Adherence Report Scale, and the Beliefs about Medicines Questionnaire. Data were analyzed using confirmatory factor analysis and structural equation modeling. Results: Three of the five investigated personality traits - agreeableness, conscientiousness, and neuroticism - were associated with both concerns about asthma medication and adherence behavior. Concerns functioned as a partial mediator for the influencing effects of agreeableness, conscientiousness, and neuroticism on adherence behavior. Conclusion: The findings suggest that personality traits could be used to identify individuals with asthma who need support with their adherence behavior. Additionally, targeting concerns about asthma medication in asthmatics with low levels of agreeableness or conscientiousness or high levels of neuroticism could have a favorable effect on their adherence behavior.
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| 12. |
- Axelsson, Malin, 1964-, et al.
(författare)
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The influence of personality traits on reported adherence to medication in individuals with chronic disease : An Epidemiological study in West Sweden
- 2011
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 6:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Limited research exists exploring the influence of personality on adherence behaviour. Since non-adherence is a major obstacle in treating prevalent chronic diseases the aim was to determine whether personality traits are related to reported adherence to medication in individuals with chronic disease. Methodology/Principal Findings: Individuals with chronic disease (n = 749) were identified in a random population sample of 5000 inhabitants aged 30-70 in two municipalities in West Sweden. Data on five personality traits, Neuroticism, Extraversion, Openness to experiences, Agreeableness, and Conscientiousness, and medication adherence behaviour was collected by questionnaires. Statistical analyses resulted in a negative relationship between Neuroticism and medication adherence (P<0.001), while both Agreeableness (P<0.001) and Conscientiousness (P<0.001) were positively related to adherence. At high levels of Conscientiousness, low adherence was related to higher scores in Neuroticism. At high levels of Agreeableness, low adherence was related to low scores in Conscientiousness and high scores in Openness to experiences. Conclusions: This study demonstrated that multiple personality traits are of significant importance for adherence behaviour in individuals with chronic disease. The findings suggest that several personality traits may interact in influencing adherence behaviour. Personality traits could putatively be used to focus efforts to educate and support patients with high risk of low medical adherence. © 2011 Axelsson et al.
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| 13. |
- Ekerljung, Linda, 1979, et al.
(författare)
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Five-fold increase in use of inhaled corticosteroids over 18 years in the general adult population in West Sweden.
- 2014
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Ingår i: Respiratory medicine. - : Elsevier BV. - 1532-3064 .- 0954-6111. ; 108:5, s. 685-693
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Tidskriftsartikel (refereegranskat)abstract
- Asthma medication was increasingly used during the second part of the past century. There are few detailed data from population studies on use of asthma medication. The current study aimed to determine the use and determinants of asthma medication in West Sweden and to assess changes during the last two decades.
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| 14. |
- Mincheva, Roxana, 1986, et al.
(författare)
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Frequent cough in unsatisfactory controlled asthma - results from the population-based West Sweden Asthma Study
- 2014
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Ingår i: Respiratory Research. - : Springer Science and Business Media LLC. - 1465-993X .- 1465-9921. ; 15:79
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Tidskriftsartikel (refereegranskat)abstract
- Background: Asthma is a complex disease presenting with variable symptoms which are sometimes hard to control. The purpose of the study was to describe the prevalence of asthma symptoms, use of asthma medications and allergic sensitization in subjects with asthma. We also related those indices to the level of asthma control, lung function and in particular, cough. Methods: An extensive questionnaire was sent to randomly selected adults from the West Sweden region. Clinical examinations and interview were performed in a subset. Of the participants, 744 were defined as having an ongoing asthma - reported ever having asthma or physician diagnosed asthma and one of the following - use of asthma medications, recurrent wheeze or attacks of shortness of breath with or without wheeze in the last 12 months. A respiratory disease-free control group of 847 subjects was also described. Results: According to GINA guidelines, 40.6% of the asthmatics had partly controlled and 17.8% had uncontrolled asthma. Asthmatic subjects reported significantly more symptoms in the last 12 months than the control group - wheezing (79.4 vs 9.2%), shortness of breath (36.1 vs 2.5%), wheezing with shortness of breath (58.7 vs 1.3%). Important complaints were morning cough (42.5 vs 15.5%), cough with sputum production (36.1 vs 6.8%) and longstanding cough (32.5 vs 11.1%), which bothered two thirds of the uncontrolled and one third of partly controlled subjects. Asthma medications were used by 87.5% of the asthmatics, although around 30% of them who had insufficiently controlled disease used only short-acting beta-agonists. Asthmatics also had lower lung function, reacted to lower doses of methacholine that the controls and 13.6% of them had a FEV1/FVC ratio below 0.7. Allergic rhinitis was reported by 73.8% of the asthmatics and they were more frequently sensitized to several common allergens. Conclusions: Approximately 60% of asthmatics from this population-based study had insufficiently controlled asthma and persistent complaints, despite a high use of asthma medications. These self-reported symptoms were supported by clinical examination data. Increased cough frequency is an indicator of a more severe and difficult to control disease and should be considered when asthma is characterized.
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