@文章{信息:doi/10.2196/14006，作者=" audron - pontevia, Anne-Fran{\c{c}}oise and Menvielle, Loick and Ertz, Myriam"，标题="对点对点在线健康社区用户的患者依从性的三个前因变量的影响:横向研究"，期刊="J Med Internet Res"，年="2019"，月="11"，日="11"，卷="21"，数="11"，页数="e14006"，关键词="在线社交网络;病人权利;病人的依从性;病人满意度;背景:在过去的50年里，患者不服从已经成为一个主要的公共卫生问题和大量研究的焦点，因为它危及患者的康复，并对卫生保健系统施加了相当大的财政负担。与此同时，在线健康社区(OHCs)正变得越来越普遍，通常由有健康问题的个人使用，它们可能在促进合规方面发挥作用。尽管越来越受欢迎，但对OHCs用户的患者依从性预测因素知之甚少。目的:本研究旨在调查参与OHCs在多大程度上可能引发更高水平的依从性。它确定了3个可能影响患者依从性的相互关联的预测因素:通过对等OHCs获得的患者赋权、对医生的满意度和对医生的承诺。方法:一项基于网络的调查测试了概念模型，并评估了通过OHCs获得的患者赋权对患者满意度和对医生的承诺的影响，以及这3个预测因素对患者对拟议治疗依从性的影响。 Members of peer-to-peer OHCs were asked to answer an online questionnaire. A convenience sample of 420 patients experiencing chronic illness and using peer-to-peer OHCs was surveyed in August 2018 in Qu{\'e}bec, Canada. A path analysis using structural equation modeling tested the proposed relationships between the predictors and their respective paths on patient compliance. The mediation effects of these predictor variables on patient compliance were estimated with the PROCESS macro in SPSS. Results: The findings indicated that patient empowerment gained through OHCs was positively related to patient commitment to the physician (beta=.69; P<.001) and patient compliance with the proposed treatment (beta=.35; P<.001). Patient commitment also positively influenced patient compliance (beta=.74; P<.001). Patient empowerment did not exert a significant influence on patient satisfaction with the physician (beta=.02; P=.76), and satisfaction did not affect compliance (beta=−.07; P=.05); however, patient satisfaction was positively related to patient commitment to the physician (beta=.14; P<.01). The impact of empowerment on compliance was partially mediated by commitment to the physician (beta=.32; 95{\%} CI 0.22-0.44) but not by satisfaction. Conclusions: This study highlights the importance of peer-to-peer OHCs for two main reasons. The primary reason is that patient empowerment gained through peer-to-peer OHCs both directly and indirectly enhances patient compliance with the proposed treatment. The underlying mechanisms of these effects were shown. Second, commitment to the physician was found to play a more critical role than satisfaction with the physician in determining patient-physician relationship quality. Overall, our findings support the assumption that health care stakeholders should encourage the use of peer-to-peer OHCs to favor patient empowerment and patient commitment to the physician to increase patient compliance with the proposed treatment. ", issn="1438-8871", doi="10.2196/14006", url="//www.mybigtv.com/2019/11/e14006", url="https://doi.org/10.2196/14006", url="http://www.ncbi.nlm.nih.gov/pubmed/31710295" }