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  • 1.
    Axelsson, Malin
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Personality and reasons for not using asthma medication in young adults2013In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 42, no 4, p. 241-246Article in journal (Refereed)
    Abstract [en]

    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.

  • 2.
    Axelsson, Malin
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Personlighetens betydelse för uppnådd och upplevd astmakontroll2011In: Fagbladet Allergi i praksis, ISSN 0806-5462, ISSN 0806-5462, p. 12-15Article in journal (Other academic)
  • 3.
    Axelsson, Malin
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Report on personality and adherence to antibiotic therapy: a population-based study2013In: BMC Psychology, E-ISSN 2050-7283, Vol. 1, no 1, p. 24-Article in journal (Refereed)
    Abstract [en]

    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.

  • 4.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Lundgren, Jesper
    University of Gothenburg, Department of Psychology.
    Lötvall, Jan
    University of Gothenburg, Krefting Research Centre, Internal Medicine, Institute of Medicine, Sahlgrenska Academy.
    The influence of personality traits on reported adherence to medication in individuals with chronic disease: An Epidemiological study in West Sweden2011In: PLoS ONE, Vol. 6, no 3Article in journal (Refereed)
    Abstract [en]

    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.

  • 5.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Lötvall, Jan
    University of Gothenburg, Krefting Research Centre, Institute of Medicine and Clinical Nutrition, Internal Medicine, Sahlgrenska Academy.
    A personality and gender perspective on adherence and health-related quality of life in people with asthma and/or allergic rhinitis.2014In: Journal of the American Association of Nurse Practitioners, ISSN 2327-6886, E-ISSN 2327-6924, Vol. 26, no 1, p. 32-39Article in journal (Refereed)
    Abstract [en]

    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.

  • 6.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet.
    Lundgren, Jesper
    Avdelningen för psykologi, Göteborgs Universitet.
    Patients´ adherence reasoning in relation to asthma medication2011In: 30th Congress of the European Academy of Allergy and Clinical Immunology in Istanbul, 11-15 june 2011, 2011Conference paper (Refereed)
  • 7.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Cliffordson, Christina
    University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences.
    Lundbäck, Bo
    Krefting Research Centre, Göteborgs universitet.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet.
    The function of medication beliefs as mediators between personality traits and adherence behavior in people with asthma2013In: Patient Preference and Adherence, ISSN 1177-889X, E-ISSN 1177-889X, Vol. 7, p. 1101-1109Article in journal (Refereed)
    Abstract [en]

    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.

  • 8.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Emilsson, Maria
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Lundgren, J.
    University of Gothenburg, Department of Psychology.
    Torén, K.
    University of Gothenburg, Sahlgrenska Academy, Department of Community Medicine.
    Lötvall, J.
    University of Gothenburg, Sahlgrenska Academy, Department of Internal Medicine.
    Personality, adherence, asthma control and health-related quality of life in young adult asthmatics2009In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 103, no 7, p. 1033-1040Article in journal (Refereed)
  • 9.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Division of Nursing. University West, Department of Health Sciences, Section for nursing - graduate level.
    Lötvall, Jan
    Krefting Research Center, Göteborgs universitet.
    Recent educational interventions for improvement of asthma medication adherence.2012In: Asia Pacific allergy, ISSN 2233-8276, Vol. 2, no 1, p. 67-75Article in journal (Refereed)
    Abstract [en]

    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.

  • 10.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Lötvall, Jan
    Krefting Research Centre, Institute of Medicine, Internal Medicine, Sahlgrenska Academy, University of Gothenburg.
    Cliffordson, Christina
    University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.
    Lundgren, Jesper
    Department of Psychology, University of Gothenburg.
    Brink, Eva
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Self-efficacy and adherence as mediating factors between personality traits and health-related quality of life2013In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 22, no 3, p. 567-575Article in journal (Refereed)
    Abstract [en]

    Purpose Personality traits are rather stable dispositions inadulthood, while self-efficacy and adherence may bemodified through targeted interventions. Health-relatedquality of life (HRQL) serves as a vital outcome measure.The present aim was to explore the function of self-efficacyand adherence as mediators for the influencing effect ofpersonality traits on HRQL in people with chronic disease.Methods An epidemiological sample of 786 personscompleted questionnaires on personality, general self-efficacy,adherence behaviour and HRQL. Data were statisticallyanalysed using descriptive statistics, correlationanalyses and path models.Results Self-efficacy mediated the effect of Extraversionand Conscientiousness on mental HRQL. Neuroticism hada direct effect on both physical and mental HRQL.Adherence partially mediated the effect of both Agreeablenessand Conscientiousness on mental HRQL.Conclusions The mental HRQL in people scoring low onExtraversion or low on Conscientiousness could beimproved by strengthening general self-efficacy. Increasingadherence in people scoring low on Agreeableness orConscientiousness could improve their mental HRQL, butthe improvement was small and may be of lesser clinicalrelevance. These results argue for personalized interventionsintended to positively affect health outcomes inpeople with chronic disease.

  • 11.
    Axelsson, Malin
    et al.
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, undergraduate level.
    Lötvall, Jan
    Krefting Research Centre, Institute of Medicine, Internal Medicine, Sahlgrenska Academy, University of Gothenburg.
    Lundgren, Jesper
    Department of Psychology, University of Gothenburg.
    Brink, Eva
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Motivational foci and asthma medication tactics directed towards a functional day2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, p. 809-Article in journal (Refereed)
    Abstract [en]

    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 them

    towards 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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