Improving Medication Adherence in Community-Dwelling Patients with Schizophrenia Through Therapeutic Alliance and Medication Attitude: A Serial Multiple Mediation Model

Figures & data

Figure 1 The serial mediation model in this study.

Notes: X = independent variable; Y = dependent variable; M₁, M₂ = mediators; a₁, a₂, b₁, b₂, d, c, c’ = unstandardized regression coefficients; a₁ = X on M₁; a₂ = X on M₂; b₁ =M₁ on Y; b₂ = M₂ on Y; d = M₁ on M₂; c = total effect of X on Y; c’ = direct effect of X on Y.

Table 1 Description of Patient Demographics and Main Variables (n = 229)

	Descriptive Statistics	Inferential Statistics
Characteristics	N (%)/ Mean ± SD	t^a/F^b/r^c	p
Age	46.9 ± 8.63	0.06^c	0.410
Gender		1.28^a	0.201
Male	128 (55.90)
Female	101 (44.10)
Education level		0.10^b	0.902
Junior or below	96 (41.92)
Senior high School	108 (47.16)
College or higher	25 (10.92)
Employment		−0.17^a	0.864
No	178 (77.73)
Yes	51 (22.27)
Marital status		1.36^b	0.258
Single	148 (64.63)
Married	48 (20.96)
Divorced/widowed	33 (14.41)
Illness duration	21.78 ± 9.11	0.06^c	0.340
Number of hospitalizations	5.53 ± 6.62	−0.24^c	< 0.001
Global function	64.72 ± 15.32	0.15^c	0.026
Psychotic symptoms	12.63 ± 7.33	−0.09^c	0.195
Insight	24.72 ± 5.35	0.25^c	< 0.001
Therapeutic alliance	60.01 ± 12.47	0.44^c	< 0.001
Medication attitude	5.47 ± 3.63	0.61^c	< 0.001
Medication adherence	5.83 ± 2.47	–	–

Notes: ^a t-test (t); ^bANOVA (F); ^cPearson’s correlation (r).

Figure 2 The serial mediation results in this study (A-C).

Notes: X = independent variable; Y = dependent variable; M₁, M₂ = mediators; A is the simple mediation model (pathway a₁b₁: X→M₁→Y). B is the simple mediatiom model (pathway a₂b₂: X→M₂→Y). C is the serial mediation model (pathway: X→M₁→M₂→Y). a₁, a₂, b₁, b₂, d, c, c’ = unstandardized regression coefficients; a₁ = X on M₁; a₂ = X on M₂; b₁ =M₁ on Y; b₂ = M₂ on Y; d = M₁ on M₂; c = total effect of X on Y; c’ = direct effect of X on Y. The coefficient of pathway c does not consider the mediator, the total effect of insight on medication adherence. The coefficient of pathway c’ considers the mediators, the direct effect of insight on medication adherence, not including the mediating effect. If pathway c’ is not significant, after considering M₁ and M₂, the effect of insight on medication adherence becomes non-significant.