Abstract
BACKGROUND: A comprehensive understanding of the strategies that promote adherence is important for achieving optimal health outcomes in patients after percutaneous coronary intervention. OBJECTIVE: The aim of this study was to investigate the associations within Adherence Theory for patients with chronic disease after percutaneous coronary intervention during a long-term follow-up. DESIGN: A descriptive and exploratory study design was used in this study, with a survey conducted at 2 time points over 6 years. METHODS: Structural equation modeling was used to evaluate the model with baseline data from 2013 (n = 416) and follow-up data from 2019 (n = 167). The instruments used included the Adherence of Patients with Chronic Diseases and Social Support of People with Coronary Heart Disease questionnaires. RESULTS: Adherence Theory for patients with chronic disease showed a robust structure with no significant differences between 2013 and 2019. However, significant gender differences were observed in both years. Motivation was directly associated with adherence in 2013. For men, indirect associations were found between informational support, sense of normality, support from next of kin, and results of care. Adherence for women was not influenced by any identifiable factors in 2019, as observed in 2013. Among men, motivation was directly associated with adherence and indirectly linked to a sense of normality, fear of complications, and support from next of kin. CONCLUSIONS: The results underscore the importance of critically reassessing nursing theories to ensure their relevance. This research-based knowledge can then be used to develop nursing interventions that promote person-centered care.