ارتباط تبعیت درمانی با افسردگی در بیماران مبتلا مالتیپل اسکلروز (ms)؛ نقش تعدیل‌گر کارکردهای اجرایی

مقدمه: پژوهش باهدف بررسی نقش تعدیل‌گر کارکردهای اجرایی در ارتباط بین تبعیت درمانی با افسردگی در بیماران مبتلابه مالتیپل اسکلروز انجام شد.روش: طرح پژوهش از نوع توصیفی و همبستگی و جامعه شامل تمامی مبتلایان به بیماری مالتیپل اسکلروز ساکن تهران بود. درنهایت 229 نفر نمونه به شیوه در دسترس انتخاب شدند و به پرسشنامه‌های افسردگی بک ویرایش دوم (2005)، کارکردهای اجرایی نجاتی و همکاران (2014) و تبعیت درمانی موریسکی و همکاران (2008) به شیوه مداد کاغذی پاسخ دادند. به منظور بررسی ارتباط از همبستگی پیرسون و نقش تعدیل‌گر از رگرسیون گام‌به‌گام بهره گرفته شد.یافته‌ها: شواهدی از نقش پیش‌بین نشانه‌های افسردگی برای تبعیت ضعیف از درمان در بیماران مبتلا به مالتیپل اسکلروز یافت شد (p<0/01). بعلاوه شواهد مبین نقش پیش‌بین حافظه، برنامه‌ریزی و شناخت اجتماعی در تبعیت درمانی بود (p<0/01). از طرفی شواهدی از نقش کارکردهای اجرایی در رابطه نشانه‌های افسردگی با تبعیت درمانی به عنوان تعدیل یافت نشد (p>0/01).نتیجه‌گیری: یافته‌ها حاکی از اهمیت وجود نشانه‌های افسردگی و کارکردهای اجرایی در تبعیت درمانی بیماران مبتلابه مالتیپل اسکلروز بود. با توجه به اهمیت تبعیت درمانی در پیش‌آگهی بیماری پیشنهاد می‌شود پزشکان با در نظر گرفتن این دومورد به تدوین برنامه‌هایی درمانی اقدام کنند تا مشکلات شناختی و هیجانی موازی با درمان اصلی بیماری هدف قرار دهند و از این طریق تبعیت درمانی را افزایش دهند.

the relationship between treatment adherence and depression in multiple sclerosis (ms) patients; the moderating role of executive functions

objective: this study aimed to explore the role of executive functions in moderating the relationship between medication adherence and depression among individuals with multiple sclerosis (ms). ms is a chronic disease that affects the central nervous system, and both cognitive and emotional factors can significantly influence how patients adhere to treatment plans. medication adherence is crucial for disease management, and depression is a common comorbidity in ms patients, often complicating adherence. understanding the relationship between depression, cognitive functions, and treatment adherence can help improve therapeutic outcomes. method: this research was conducted as a descriptive-correlational study, targeting ms patients residing in tehran. the sample consisted of 229 participants, selected through convenience sampling. these individuals completed three standardized questionnaires: the beck depression inventory (second edition, 2005), the executive function questionnaire by najafi et al. (2014), and the morisky medication adherence scale (2008). data collection was done through a paper-and-pencil survey method. to analyze the data, pearson’s correlation coefficient was used to examine relationships between variables, and stepwise regression analysis was performed to determine if executive functions moderate the relationship between depression and medication adherence. results: the study found that depressive symptoms were a significant predictor of poor medication adherence in ms patients (p<0.01). this suggests that patients with higher levels of depression are more likely to struggle with adhering to their treatment regimens. additionally, executive functions such as memory, planning, and social cognition were found to significantly predict medication adherence (p<0.01). these cognitive abilities likely help patients better manage their treatment schedules and follow medical instructions. however, the study did not find evidence supporting the role of executive functions as a moderator in the relationship between depressive symptoms and medication adherence (p>0.01). this indicates that while cognitive abilities and depression are related to medication adherence, executive functions do not appear to change the strength or direction of the relationship between depression and adherence. conclusion: the findings highlight the importance of both depressive symptoms and executive functions in influencing medication adherence in ms patients. given that poor medication adherence can lead to worse health outcomes, addressing both cognitive and emotional barriers to treatment is critical. healthcare providers should consider these factors when designing treatment plans for ms patients. for example, interventions aimed at improving executive functions, such as memory and planning, as well as addressing depression, may be beneficial. by targeting both cognitive and emotional challenges, providers can help patients better adhere to their treatment regimens, which could ultimately improve disease prognosis and quality of life. furthermore, healthcare teams should be aware of the multifaceted nature of treatment adherence and incorporate psychological and cognitive assessments into routine care to ensure comprehensive support for ms patients. in conclusion, while executive functions may not moderate the relationship between depression and adherence, they are still crucial in predicting adherence, suggesting that an integrated approach to treatment planning is vital for enhancing medication compliance in ms patients.