Resumo
Objective. The effects of a common-sense and self-regulation model-based intervention to increase adherence behaviors and asthma control were valuated. Method. We tested an A-B and follow-up design, replicating the intervention with five women, ages between 25 and 55. The treatment was applied over three 90-minute sessions based on the following strategies: psychoeducation, reattribution, problem-solving, and objective feedback. Effects were assessed with standardized and behavioral measures of adherence, asthma control and pulmonary obstruction measurement over a period of 28-75 days, using visual analysis, effect size and clinical significance. Results. The increase in adherence behaviors for phase B and follow-up had a moderate-strong effect (NAP = .86-1, p < .01). In the case of asthma control, there were significant clinical effects (RCI = 2.32-5.42), as well as in pulmonary obstruction where patients decreased it between 11%-40%.
Referências
Achstetter, L. I., Schultz, K., Faller, H., & Schuler, M. (2016). Leventhal’s common-sense model and asthma control: Do illness representations predict success of an asthma rehabilitation? Journal of Health Psychology, 24(3), 327-336. https://doi.org/10.1177/1359105316651332
Alfonsson, S., Englund, J., & Parling, T. (2019). Tailored text message prompts to increase therapy homework adherence: A single-case randomised controlled study. Behaviour Change, 36(3), 180-191. https://doi.org/10.1017/bec.2019.10
Aujla, N., Walker, M., Sprigg, N., Abrams, K., Massey, A., & Vedhara, K. (2016). Can illness beliefs, from the common-sense model, prospectively predict adherence to self-management behaviours? A systematic review and meta-analysis. Psychology & Health, 31(8), 931-958. https://doi.org/10.1080/08870446.2016.1153640
Balcazar, F., Hopkins, B. L., & Suarez, Y. (1985). A critical, objective review of performance feedback. Journal of Organizational Behavior Management, 7(3-4), 65-89. https://doi.org/10.1300/j075v07n03_05
Brandes, K., & Mullan, B. (2014). Can the common-sense model predict adherence in chronically ill patients? A meta-analysis. Health Psychology Review, 8(2), 129-153. https://doi.org/10.1080/17437199.2013.820986
Breland, J. Y., Wong, J. J., & McAndrew, L. M. (2020). Are Common Sense Model constructs and self-efficacy simultaneously correlated with self-management behaviors and health outcomes: A systematic review. Health Psychology Open, 7(1), 1-13. https://doi.org/10.1177/2055102919898846
Cardiel, R. (1994). La medición de la calidad de vida. En L. Moreno, F. Cano-Valle & H. García-Romero (Eds.). Epidemiología clínica (pp. 189-199). Interamericana-McGraw-Hill.
Chan, A. H. Y., Horne, R., Hankins, M., & Chisari, C. (2020). The Medication Adherence Report Scale: A measurement tool for eliciting patients' reports of nonadherence. British Journal of Clinical Pharmacology, 86(7), 1281-1288. https://doi.org/10.1111/bcp.14193
Chapman, S. C. E., Barnes, N., Barnes, M., Wilkinson, A., Hartley, J., Piddock, C., Weinman, J., & Horne, R. (2015). Changing adherence-related beliefs about ICS maintenance treatment for asthma: Feasibility study of an intervention delivered by asthma nurse specialists. BMJ Open, 5(6), 1-9. https://doi.org/10.1136/bmjopen-2014-007354
Chapman, S., Dale, P., Svedsater, H., Stynes, G., Vyas, N., Price, D., & Horne, R. (2017). Modelling the effect of beliefs about asthma medication and treatment intrusiveness on adherence and preference for once-daily vs. twice-daily medication. Npj Primary Care Respiratory Medicine, 27(1), 1-11. https://doi.org/10.1038/s41533-017-0061-7
Clarkesmith, D., Pattison, H., Borg-Xuereb, C., & Lane, D. (2016). Developing a Complex Educational-Behavioural Intervention: The TREAT intervention for patients with atrial fibrillation. Healthcare, 4(1), 10. https://doi.org/10.3390/healthcare4010010
Degroote, L., De Paepe, A., De Bourdeaudhuij, I., Van Dyck, D., & Crombez, G. (2021). Effectiveness of the mHealth intervention ‘MyDayPlan’ to increase physical activity: An aggregated single case approach. International Journal of Behavioral Nutrition and Physical Activity, 18(1), 1-12. https://doi.org/10.1186/s12966-021-01163-2
Dugas, M., Gao, G., & Agarwal, R. (2020). Unpacking mHealth interventions: A systematic review of behavior change techniques used in randomized controlled trials assessing mHealth effectiveness. Digital Health, 6, 1-16. https://doi.org/10.1177/2055207620905411
Foot, H., La Caze, A., Baker, P., & Cottrell, N. (2019). Better understanding the influence and complexity of beliefs on medication adherence in asthma. Patient Education and Counseling, 102(3), 564-570. https://doi.org/10.1016/j.pec.2018.10.010
Foot, H., La Caze, A., Gujral, G., & Cottrell, N. (2016). The necessity-concerns framework predicts adherence to medication in multiple illness conditions: A meta-analysis. Patient Education and Counseling, 99(5), 706-717. https://doi.org/10.1016/j.pec.2015.11.004
Ghaemian, A., Ghomi, M., Wrightman, M., & Ellis-Nee, C. (2020). Therapy discontinuation in a primary care psychological service: why patients drop out. Cognitive Behaviour Therapist, 13, e25. https://doi.org/10.1017/s1754470x20000240
Glanz, K., & Kegler, M. C. (2012). Processes of health behavior change. In A. Baum, T. A. Revenson & J. Singer (Eds.), Handbook of Health Psychology (pp. 99-112). Routledge.
Global Initiative for Asthma. (2019). Global Strategy for Asthma Management and Prevention. www.ginasthma.org
Guillén, C., González-Celis, A. L., Cruz-Peralta, M. J., Mendoza-Madrigal, V. A., Reyes-Jarquín, K., & Bautista-Díaz, M. L. (2020). Efectos de una intervención cognitivo conductual para mujeres con síntomas de depresión y asma no controlada. Revista Latinoamericana de Medicina Conductual, 10(2), 23-35. https://www.revistas.unam.mx/index.php/rlmc/article/view/79730
Hagger, M. S., & Orbell, S. (2021). The common sense model of illness self-regulation: a conceptual review and proposed extended model. Health Psychology Review, 16(3). 347-377. https://doi.org/10.1080/17437199.2021.1878050
Heller, M. K., Chapman, S. C. E., & Horne, R. (2015). Beliefs about medication predict the misattribution of a common symptom as a medication side effect - Evidence from an analogue online study. Journal of Psychosomatic Research, 79(6), 519-529. https://doi.org/10.1016/j.jpsychores.2015.10.003
Hoogeboom, T. J., Kwakkenbos, L., Rietveld, L., Den Broeder, A. A., De Bie, R. A., & Van den Ende, C. H. M. (2012). Feasibility and potential effectiveness of a non-pharmacological multidisciplinary care programme for persons with generalised osteoarthritis: A randomised, multiple-baseline single-case study. BMJ Open, 2(4), 1-9. https://doi.org/10.1136/bmjopen-2012-001161
Horne, R., Chapman, S. C. E., Parham, R., Freemantle, N., Forbes, A., & Cooper, V. (2013). Understanding patients’ adherence-related Beliefs about Medicines prescribed for long-term conditions: A meta-analytic review of the Necessity-Concerns Framework. PLoS ONE, 8(12), e80633. https://doi.org/10.1371/journal.pone.0080633
Horne, R., Cooper, V., Wileman, V., & Chan, A. (2019). Supporting adherence to medicines for long-term conditions. European Psychologist, 24(1), 82-96. https://doi.org/10.1027/1016-9040/a000353
Horne, R., Price, D., Cleland, J., Costa, R., Covey, D., Gruffydd-Jones, K., Haughney, J., Henrichsen, S. H., Kaplan, A., Langhammer, A., Østrem, A., Thomas, M., Van der Molen, T., Virchow, J. C., & Williams, S. (2007). Can asthma control be improved by understanding the patient’s perspective? BMC Pulmonary Medicine, 7, 1-11. https://doi.org/10.1186/1471-2466-7-8
Horne, R., Weinman, J., & Hankins, M. (1999). The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychology & Health, 14(1), 1-24. https://doi.org/10.1080/08870449908407311
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychologv, 59(1), 12-19. https://doi.org/10.1037/0022-006X.59.1.12
Jones, C., Smith, H. E., & Llewellyn, C. D. (2016). A systematic review of the effectiveness of interventions using the Common Sense Self-Regulatory Model to improve adherence behaviours. Journal of Health Psychology, 21(11), 2709-2724. https://doi.org/10.1177/1359105315583372
Kosse, R. C., Bouvy, M. L., De Vries, T. W., & Koster, E. S. (2019). Effect of a mHealth intervention on adherence in adolescents with asthma: A randomized controlled trial. Respiratory Medicine, 149, 45-51. https://doi.org/10.1016/j.rmed.2019.02.009
Kosse, R. C., Koster, E. S., Kaptein, A. A., De Vries, T. W., & Bouvy, M. L. (2020). Asthma control and quality of life in adolescents: The role of illness perceptions, medication beliefs, and adherence. Journal of Asthma, 57(10), 1145-1154. https://doi.org/10.1080/02770903.2019.1635153
Kratochwill, T. R., Hitchcock, J. H., Horner, R. H., Levin, J. R., Odom, S. L., Rindskopf, D. M., & Shadish, W. R. (2013). Single-case intervention research design standards. Remedial and Special Education, 34(1), 26-38. https://doi.org/10.1177/0741932512452794
Kucukarslan, S. N. (2012). A review of published studies of patients’ illness perceptions and medication adherence: Lessons learned and future directions. Research in Social and Administrative Pharmacy, 8(5), 371-382. https://doi.org/10.1016/j.sapharm.2011.09.002
Kucukarslan, S., Plumley, D., Chang, A., & Ueda, A. (2014). Intending to adhere or to not adhere: Results from an experiment in healthy subjects testing illness perceptions and behavioral intentions in asthma. Research in Social and Administrative Pharmacy, 10(1), 239-245. https://doi.org/10.1016/j.sapharm.2013.05.001
Kurti, A. N., & Dallery, J. (2014). Integrating technological advancements in behavioral interventions to promote health: unprecedented opportunities for behavior analysts. Revista Mexicana de Análisis de la Conducta, 40(2), 106-126. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358800/
Kwasnicka, D., Inauen, J., Nieuwenboom, W., Nurmi, J., Schneider, A., Short, C. E., Dekkers, T., Williams, A. J., Bierbauer, W., Haukkala, A., Picariello, F., & Naughton, F. (2019). Challenges and solutions for N-of-1 design studies in health psychology. Health Psychology Review, 13(2), 163-178. https://doi.org/10.1080/17437199.2018.1564627
Lam, W. Y., & Fresco, P. (2015). Medication adherence measures: An overview. BioMed Research International, 2015(1), 1-12. https://doi.org/10.1155/2015/217047
Leventhal, H., Breland, J. Y., Mora, P. A., & Leventhal, E. A. (2010). Lay representations of illness and treatment: A framework for action. In Handbook of Behavioral Medicine (pp. 137-154). Springer New York. https://doi.org/10.1007/978-0-387-09488-5_11
Leventhal, H., Diefenbach, M., & Leventhal, E. A. (1992). Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions. Cognitive Therapy and Research, 16(2), 143-163. https://doi.org/10.1007/BF01173486
Lugo-González, I. V. (2023). Manual psicoeducativo para mejorar el apego al medicamento de control en pacientes con asma. Universidad Nacional Autónoma de México/ Iztacala. https://www.mciztacala.org/uploads/1/3/2/8/132887507/3_manual_asma.pdf
Lugo-González, I. V., Fernández-Vega, M., Pérez-Bautista, Y. Y., & Vega, Z. (2020). Propiedades psicométricas del Cuestionario Revisado de Percepción de Enfermedad (IPQ-R) en adultos mexicanos con asma. Revista Digital Internacional de Psicología y Ciencia Social, 6(2), 388-413. https://doi.org/10.22402/j.rdipycs.unam.6.2.2020.271.388-413
Lugo-González, I. V., González-Betanzos, F., Robles-Montijo, S., & Vega, C. Z. (2022). Psychometric properties of the Beliefs about Medicines Questionnaire (BMQ) in Mexican adults with asthma. International Journal of Psychology & Psychological Therapy, 22(1), 33-43. https://www.ijpsy.com/volumen22/num1/606.html
Lugo-González, I. V., & Pérez-Bautista, Y. Y. (2023). Validación y análisis de legibilidad de un manual psicoeducativo para favorecer conductas de adherencia en adultos con asma. Revista de psicología y ciencias del comportamiento de la unidad académica de ciencias jurídicas y sociales, 14(2), 24-35. https://doi.org/10.29059/rpcc.20231201-160
Lugo-González, I. V., Reynoso-Erazo, L., & Fernández-Vega, M. (2016). Efecto de una intervención cognitivo-conductual sobre ansiedad, depresión y severidad del asma en adultos. Revista Latinoamericana de Medicina Conductual, 6(5), 23-32. https://www.revistas.unam.mx/index.php/rlmc/article/view/58064
Lugo-González, I. V., & Vega, C. Z. (2020a). Propiedades psicométricas de la Medication Adherence Report Scale-Asthma en adultos asmáticos mexicanos. Psicología y Salud, 30(2), 275-285. https://doi.org/10.25009/pys.v30i2.2663
Lugo-González, I. V., & Vega, C. Z. (2020b). Conductas de adherencia al tratamiento y control del asma: El rol de la percepción del tratamiento. Interacciones: Revista de Avances en Psicología, 6(1), e222. https://doi.org/10.24016/2020.v6n1.222
Lugo-González, I. V., Vega, C. Z., González-Betanzos, F., Robles, S., & Fernández-Vega, M. (2022). Relación entre percepción de enfermedad, tratamiento, adherencia y control del asma: un análisis de mediación. Neumología y Cirugía de Tórax, 81(3), 157-164. https://dx.doi.org/10.35366/111085
Lugo-González, I. V., & Villegas, A. (2021). Adhesión al tratamiento: un problema en las enfermedades crónicas. En L. Reynoso & A. L. Becerra (Eds.), Medicina Conductual: Avances y Perspectivas (pp. 183-208). Qartuppi. https://doi.org/10.29410/QTP.21.05
Lukens, E. P., & McFarlane, W. R. (2004). Psychoeducation as evidence-based practice: Considerations for practice, research, and policy. Brief Treatment and Crisis Intervention, 4(3), 205-225. https://doi.org/10.1093/brief-treatment/mhh019
Lycett, H., Wildman, E., Raebel, E. M., Sherlock, J. P., Kenny, T., & Chan, A. H. Y. (2018). Treatment perceptions in patients with asthma: Synthesis of factors influencing adherence. Respiratory Medicine, 141, 180-189. https://doi.org/10.1016/j.rmed.2018.06.032
McAndrew, L. M., Musumeci-Szabó, T. J., Mora, P. A., Vileikyte, L., Burns, E., Halm, E. A., Leventhal, E. A., & Leventhal, H. (2008). Using the common sense model to design interventions for the prevention and management of chronic illness threats: From description to process. British Journal of Health Psychology, 13(2), 195-204. https://doi.org/10.1348/135910708X295604
McDonald, S., Quinn, F., Vieira, R., O’Brien, N., White, M., Johnston, D. W., & Sniehotta, F. F. (2017). The state of the art and future opportunities for using longitudinal n-of-1 methods in health behaviour research: A systematic literature overview. Health Psychology Review, 11(4), 307-323. https://doi.org/10.1080/17437199.2017.1316672
Méndez, I., Namihira, D., Moreno, L., & Sosa, C. (2001). El protocolo de investigación. Lineamientos para su elaboración y análisis. Trillas.
Michie, S., Wood, C. E., Johnston, M., Abraham, C., Francis, J. J., & Hardeman, W. (2015). Behaviour change techniques: The development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technology Assessment, 19(99), 1-187. https://doi.org/10.3310/hta19990
Miles, C., Arden-Close, E., Thomas, M., Bruton, A., Yardley, L., Hankins, M., & Kirby, S. E. (2017). Barriers and facilitators of effective self-management in asthma: Systematic review and thematic synthesis of patient and healthcare professional views. NPJ Primary Care Respiratory Medicine, 27(1), 1-21. https://doi.org/10.1038/s41533-017-0056-4
Morley, S. (2015). Single cases are complex. Illustrated by Flink et al. ‘Happy despite pain: A pilot study of a positive psychology intervention for patients with chronic pain’. Scandinavian Journal of Pain, 7(1), 55-57. http://dx.doi.org/10.1016/j.sjpain.2015.02.004
Nathan, R. A., Sorkness, C. A., Kosinski, M., Schatz, M., Li, J. T., Marcus, P., Murray, J. J., & Pendergraft, T. B. (2004). Development of the Asthma Control Test: A survey for assessing asthma control. Journal of Allergy and Clinical Immunology, 113(1), 59-65. https://doi.org/10.1016/j.jaci.2003.09.008
Nock, M. K., Belle-Janis, I., & Weding, M. M. (2008). Research designs. In A. M. Nezu & C. M. Nezu (Eds.), Evidence-based outcome research: A practical guide to conducting randomized controlled trials for psychosocial interventions (pp. 201-218). Oxford.
Parker, R. I., Vannest, K. J., Davis, J. L., & Sauber, S. B. (2011). Combining nonoverlap and trend for single-case research: Tau-U. Behavior Therapy, 42(2), 284-299. https://doi.org/10.1016/j.beth.2010.08.006
Petrie, K. J., Perry, K., Broadbent, E., & Weinman, J. (2012). A text message programme designed to modify patients’ illness and treatment beliefs improves self-reported adherence to asthma preventer medication. British Journal of Health Psychology, 17(1), 74-84. https://doi.org/10.1111/j.2044-8287.2011.02033.x
Riaz, S., & Jones, J. D. (2019). A pilot study of a text messaging intervention to modify illness and medication beliefs among patients diagnosed with inflammatory bowel disease. Journal of Technology in Behavioral Science, 4(1), 42-52. https://doi.org/10.1007/s41347-018-0083-1
Rodin, J. (1983). Behavioral medicine: beneficial effects of self control training in aging. Applied Psychology, 32(2), 153-181. https://doi.org/10.1111/j.1464-0597.1983.tb00901.x
Sánchez-Cervantes, C. T., Guillén, C., & Mendoza Madrigal, V. A. (2021). Calidad de vida general, depresión y ansiedad: diferencias de acuerdo con el control del asma. Actualidades en Psicología, 35(131), 35-50. https://doi.org/10.15517/ap.v35i131.41887
Tate, R. L., Perdices, M., Rosenkoetter, U., McDonald, S., Togher, L., Shadish, W., Horner, R., Kratochwill, T., Barlow, D. H., Kazdin, A., Sampson, M., Shamseer, L., & Vohra, S. (2016). The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016: Explanation and elaboration. Archives of Scientific Psychology, 4(1), 10-31. https://doi.org/10.1037/arc0000027
Unni, E., & Shiyanbola, O. O. (2016). Clustering medication adherence behavior based on beliefs in medicines and illness perceptions in patients taking asthma maintenance medications. Current Medical Research and Opinion, 32(1), 113-121. https://doi.org/10.1185/03007995.2015.1105204
Vannest, K. J., & Ninci, J. (2015). Evaluating intervention effects in single-case research designs. Journal of Counseling and Development, 93(4), 403-411. https://doi.org/10.1002/jcad.12038
Vázquez, G. J. C., & Salas, H. J. (2017). Guía Mexicana del Asma 2017. Neumología y Cirugía de Tórax, 76(1), 137. https://doi.org/ISSN 0028-3746
Walter, T., Hale, L., & Smith, C. (2015). Blue prescription: a single-subject design intervention to enable physical activity for people with stroke. International Journal of Therapy & Rehabilitation, 22(2), 87-95. https://doi.org/10.12968/ijtr.2015.22.2.87
Zetterberg, H., Flink, I., Spörndly-Nees, S., Wagner, S., Karlsten, R., & Åsenlöf, P. (2022). Behavioral medicine physiotherapy in the context of return to work for chronic pain: A single-case experimental design study. International Journal of Environmental Research and Public Health, 19(3), 1-24. https://doi.org/10.3390/ijerph19031509
Zurita-Cruz, J. N., Márquez-González, H., Miranda-Novales, G., & Villasís-Keever, M. Á. (2018). Estudios experimentales: diseños de investigación para la evaluación de intervenciones en la clínica. Revista Alergia México, 65(2), 178-186. https://doi.org/10.29262/ram.v65i2.376
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