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J Pediatr Psychol. 2004 Apr-May;29(3):157-69.

Pediatric adherence as a multidimensional and dynamic construct, involving a triadic partnership.

Author information

1
McGill University Health Center, Division of Clinical Epidemiology, Montréal, Québec, Canada. mirella@epimgh.mcgill.ca

Erratum in

  • J Pediatr Psychol. 2004 Jul-Aug;29(5):following 404.

Abstract

OBJECTIVE:

The aim of this paper is to integrate and draw attention to research findings that support our conceptualization of adherence as being multidimensional, dynamic, and involving a triadic partnership.

METHODS:

A review of relevant articles found in Medline, PsychLit, and reference lists provided in pertinent articles was performed.

RESULTS:

Significant progress has been made in identifying disease-related and psychosocial correlates of pediatric adherence and in developing intervention programs to promote adherence. Both lines of work have proceeded without a unifying framework for conceptualizing and measuring pediatric adherence. We offer a model that views adherence as comprising three defining aspects: (a) multidimensional, in support of the complexity and interrelatedness of treatment components, (b) a triadic partnership, as in mutually influential exchanges within and among the caregiver-medical team, child-medical team, and caregiver-child relationships, and (c) dynamic in relation to the notion of changes in developmental adaptive capacity, contextual characteristics, and disease course.

CONCLUSIONS:

Much work has yet to be done to validate, refine, and extend our model of adherence. Recommendations are offered for assessing each defining aspect, and a group-based methodology that accommodates longitudinal, prospective data is described.

PMID:
15131134
[Indexed for MEDLINE]

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