TY -的盟Audrain-Pontevia Anne-Francoise盟——Menvielle Loick盟——Ertz Myriam PY - 2019 DA - 2019/11/11 TI -三个先例的影响病人的依从性的点对点的用户在线健康社区:横断面研究乔- J地中海互联网Res SP - e14006六世- 21 - 11 KW -在线社交网络KW -病人授权KW -病人的依从性KW -病人满意度KW -结构方程建模AB -背景:在过去的50年里，患者不遵守医嘱已成为一个主要的公共卫生问题，并成为大量研究的焦点，因为它危及患者的康复，并给卫生保健系统带来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。对等OHCs的成员被要求回答一份在线问卷。2018年8月，在加拿大Québec对420名患有慢性疾病并使用点对点OHCs的患者进行了方便样本调查。使用结构方程建模的路径分析测试了预测因子及其各自路径对患者依从性的拟议关系。 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. SN - 1438-8871 UR - //www.mybigtv.com/2019/11/e14006 UR - https://doi.org/10.2196/14006 UR - http://www.ncbi.nlm.nih.gov/pubmed/31710295 DO - 10.2196/14006 ID - info:doi/10.2196/14006 ER -