| Popis: |
This study assesses the utility of Ajzen's (1988) Theory of Planned Behaviour (TPB) in predicting adherence to drug reduction plans in chronic pain patients. At the beginning of a ten week pain management programme, 40 participants expressed their attitudes, subjective norms, perceived control and intentions with respect to drug reduction. A measure of self-efficacy was also used. Twentynine participants opted to work on drug reduction plans and data on adherence and drug reduction was collected throughout the programme and at 1 and 18 month follow-up. Questionnaires were re-administered following pain management intervention to assess whether changes in attitudes and self-efficacy had occurred. Partial support was obtained for the TPB. Attitudes and subjective norms were found to predict intention to reduce and attitudes and, surprisingly, negative intention were found to predict actual drug reduction. The model was unable to explain any of the variance in adherence. It was suggested that this was due to the patient-controlled nature of drug reduction becoming confounded with adherence. More support was obtained for the Self-Efficacy Theory, with this variable predicting adherence, drug reduction and maintenance. Increases in self-efficacy were observed over the course of the programme with perceived barriers being the only TPB variable to change over treatment. Return rates of 100% and 79% were achieved at 1 and 18 month follow-up respectively. Follow-up at 18 months revealed some relapse in drug intake and self-efficacy but not back to pre-treatment levels. No relationship was found between nonadherence to plans and relapse in drug reduction posttreatment. Participants fell into 3 groups: 24% made no progress after intending to reduce, 38% made progress but then relapsed to varying extents and 28% made progress and did not relapse. Implications for practice and future research are discussed. |
