Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia
Authors
Purić, DankaPetrović, Marija
Živanović, Marko
Lukić, Petar
Zupan, Zorana
Branković, Marija
Ninković, Milica
Lazarević, Ljiljana
Stanković, Sanda
Žeželj, Iris
Article (Published version)
Metadata
Show full item recordAbstract
Objectives We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity).
Design То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study.
Setting Data were collected online using snowball sampling and social networks.
P...articipants After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10).
Primary and secondary outcome measures The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes.
Results Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute.
Conclusions We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients’ unfounded beliefs.
Keywords:
non-adherence / intentional non-adherence / treatment adherence / self-medication / irrational beliefs / conspiracy theories / superstition / experiences with the healthcare system / trust in the healthcare system / patient passivitySource:
BMJ Open, 2023, 13, 6, e069978-Funding / projects:
- Irrational mindset as a conceptual bridge from psychological dispositions to questionable health practices – REASON4HEALTH
DOI: 10.1136/bmjopen-2022-069978
ISSN: 2044-6055
WoS: 001034602300006
Scopus: 2-s2.0-85164211054
Institution/Community
Psihologija / PsychologyTY - JOUR AU - Purić, Danka AU - Petrović, Marija AU - Živanović, Marko AU - Lukić, Petar AU - Zupan, Zorana AU - Branković, Marija AU - Ninković, Milica AU - Lazarević, Ljiljana AU - Stanković, Sanda AU - Žeželj, Iris PY - 2023 UR - http://reff.f.bg.ac.rs/handle/123456789/4631 AB - Objectives We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity). Design То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study. Setting Data were collected online using snowball sampling and social networks. Participants After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10). Primary and secondary outcome measures The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes. Results Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute. Conclusions We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients’ unfounded beliefs. T2 - BMJ Open T1 - Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia IS - 6 SP - e069978 VL - 13 DO - 10.1136/bmjopen-2022-069978 ER -
@article{ author = "Purić, Danka and Petrović, Marija and Živanović, Marko and Lukić, Petar and Zupan, Zorana and Branković, Marija and Ninković, Milica and Lazarević, Ljiljana and Stanković, Sanda and Žeželj, Iris", year = "2023", abstract = "Objectives We aimed to (1) develop a novel instrument, suitable for the general population, capturing intentional non-adherence (iNAR), consisting of non-adherence to prescribed therapy, self-medication and avoidance of seeking medical treatment; (2) differentiate it from other forms of non-adherence, for example, smoking; and (3) relate iNAR to patient-related factors, such as sociodemographics, health status and endorsement of irrational beliefs (conspiratorial thinking and superstitions) and to healthcare-related beliefs and experiences ((mis)trust and negative experiences with the healthcare system, normalisation of patient passivity). Design То generate iNAR items, we employed a focus group with medical doctors, supplemented it with a literature search and invited a public health expert to refine it further. We examined the internal structure and predictors of iNAR in an observational study. Setting Data were collected online using snowball sampling and social networks. Participants After excluding those who failed one or more out of three attention checks, the final sample size was n=583 adult Serbian citizens, 74.4% female, mean age 39.01 years (SD=12.10). Primary and secondary outcome measures The primary, planned outcome is the iNAR Questionnaire, while smoking was used for comparison purposes. Results Factor analysis yielded a one-factor solution, and the final 12-item iNAR Questionnaire had satisfactory internal reliability (alpha=0.72). Health condition and healthcare-related variables accounted for 14% of the variance of iNAR behaviours, whereas sociodemographics and irrational beliefs did not additionally contribute. Conclusions We constructed a brief yet comprehensive measure of iNAR behaviours and related them to health and sociodemographic variables and irrational beliefs. The findings suggest that public health interventions should attempt to improve patients' experiences with the system and build trust with their healthcare practitioners rather than aim at specific demographic groups or at correcting patients’ unfounded beliefs.", journal = "BMJ Open", title = "Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia", number = "6", pages = "e069978", volume = "13", doi = "10.1136/bmjopen-2022-069978" }
Purić, D., Petrović, M., Živanović, M., Lukić, P., Zupan, Z., Branković, M., Ninković, M., Lazarević, L., Stanković, S.,& Žeželj, I.. (2023). Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia. in BMJ Open, 13(6), e069978. https://doi.org/10.1136/bmjopen-2022-069978
Purić D, Petrović M, Živanović M, Lukić P, Zupan Z, Branković M, Ninković M, Lazarević L, Stanković S, Žeželj I. Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia. in BMJ Open. 2023;13(6):e069978. doi:10.1136/bmjopen-2022-069978 .
Purić, Danka, Petrović, Marija, Živanović, Marko, Lukić, Petar, Zupan, Zorana, Branković, Marija, Ninković, Milica, Lazarević, Ljiljana, Stanković, Sanda, Žeželj, Iris, "Development of a novel instrument for assessing intentional non-adherence to official medical recommendations (iNAR-12): a sequential mixed-methods study in Serbia" in BMJ Open, 13, no. 6 (2023):e069978, https://doi.org/10.1136/bmjopen-2022-069978 . .