The influence of cultural and religious orientations on social support and its potential impact on medication adherence

Figures & data

Table 1 Demographic characteristics of patients (n=300)

Demographic characteristics	Total or mean (SD)	Medication adherence, mean (SD)
		Non-adherent (n=214)	Adherent (n=86)	P-value
Age (years)	57.6 (13.5)	57.5 (13.8)	53.6 (13.0)	0.025a
Sex, n (%)
Male	177	118 (39.3)	59 (19.7)	0.032b
Female	123	96 (32.0)	27 (9.0)
Monthly income, n (%)
≤ RM3,000	249	178 (59.3)	71 (23.7)	0.897b
> RM3,000	51	36 (12.0)	15 (5.0)
Duration of treatment (months)	103.9 (77.6)	112.2 (83.3)	83.1 (56.6)	0.005c
Number of medications prescribed	5.1 (2.7)	5.4 (2.8)	4.4 (2.5)	0.005a
Number of daily doses of medication	7.7 (4.8)	8.2 (5.0)	6.5 (4.1)	0.002a

Notes:

a student’s t-test;

b Pearson’s chi-squared test;

c Mann–Whitney U-test.

Table 2 Summary of patients’ score on cultural and religious orientations and social support domains

Variables and domains (full score)	Range of score	Mean score (SD)	Distribution of patients’ score (%)
Cultural			Agree/strongly agree (1–2)	Neutral (3)	Disagree/strongly disagree (4–5)
Group orientation (5) “I seek medical treatment or take medications because my family or friends asked me to do so”	1–5	2.2 (1.1)	199 (76.5)	6 (2.3)	55 (21.2)
Higher authority (5) “I seek medical treatment or take medications only because I feel the need to follow my doctor's orders as he/she knows what is best for me”	2–5	4.5 (0.6)	4 (1.5)	9 (3.5)	247 (95)
Religiosity			Never or ≤ once/year (1–2)	A few times in a year/month (3–4)	≥ once/week (5–6)
Organizational religious activity (6) “How often do you attend mosque, church, temple or other religious meetings?”	1–6	3.9 (1.7)	66 (22)	99 (33)	135 (45)
Non-organizational religious activity (6) “How often do you spend time in private religious activities such as payer, meditation or reading scriptures such as Al-Quran or Bible?”	1–6	4.2 (2.0)	87 (29)	23 (7.7)	190 (63.3)
Intrinsic religiosity (IR) (15)			Low IR(≤5)	Medium IR(6–10)	High IR(>I0)
“In my life, I experience the presence of the Divine eg, God” (5) “My religious beliefs are what really lie behind my whole approach to life” (5) “I try hard to carry my religion over into all other dealings in life” (5)	3–15	12.2 (3.8)	27 (9)	50 (16.7)	223 (74.3)
Social support			Very strongly disagree to mildly disagree (1–3)	Neutral (4)	Mildly agree to very strongly agree (5–7)
Family (7) “My family really tries to help me” (7) “I get the emotional help and support I need from my family” (7) “I can talk about my problems with my family” (7) “My family is willing to help me make decisions” (7)	1–7	5.8 (1.3)	23 (7.7)	33 (11)	244 (81.3)
Friends (7) “My friends really try to help me” (7) “I can count on my friends when things go wrong” (7) “I have friends with whom I can share my joys and sorrows” (7) “I can talk about my problems with my friends” (7)	1–7	4.8 (1.5)	69 (23)	70 (23.3)	161 (53.7)
Significant others (7) “There is a special person who is around me when I am in need” (7) “There is a special person with whom I can share my joys and sorrows” (7) “I have a special person who is a real source of comfort to me” (7) “There is a special person in my life who cares about my feelings” (7)	1–7	5.7 (1.6)	30 (10)	28 (9.3)	242 (80.7)
Total (7)	1–7	5.4 (1.1)	26 (8.7)	56 (18.7)	218 (72.6)

Table 3 Factors that may influence social support

Variable	Group orientation	Higher authority	ORA	NORA	IR
MSPSS
r	0.181	−0.017	0.230	0.135	0.156
P-value	0.003	0.787	<0.001	0.019	0.007

Abbreviations: ORA, organizational religious activity; NORA, non-organizational religious activity; IR, intrinsic religiosity; MSPSS, multidimensional scale of perceived social support.

Table 4 Modeling of medication adherence

Variables	Univariate analysis				Multiple logistic regression
	Crude OR	95% CI	Wald’s χ^2 (df)	P-value	Adjusted OR	95% CI	Wald’s χ^2 (df)	P-value
Age	0.98	0.96–1.00	4.92 (1)	0.027	1.05	1.02–1.08	10.0 (1)	0.002
Sex
Male	1.78	1.05–3.02	4.54 (1)	0.033
Female	1.00
Monthly income
≤ RM3,000	0.96	0.49–1.86	0.02 (1)	0.897
> RM3,000	1.00
Duration of treatment	0.99	0.99–1.00	8.38 (1)	0.004	0.99	0.99–1.00	5.01 (1)	0.025
Number of medications prescribed	0.87	0.79–0.96	7.78 (1)	0.005
Number of daily doses of medication	0.92	0.87–0.97	7.98 (1)	0.005
Group orientation	0.89	0.69–1.14	0.93 (1)	0.335
Higher authority	1.30	0.83–2.04	1.27 (1)	0.26
ORA	1.13	0.97–1.31	2.49 (1)	0.115	1.19	1.06–1.41	4.30 (1)	0.011
NORA	0.88	0.78–0.99	4.45 (1)	0.035
IR	0.99	0.93–1.06	0.06 (1)	0.811
MSPSS	0.97	0.90–1.04	0.63 (1)	0.427
Disease types: human immunodeficiency virus (Reference to: CKD)	–	–	33.5 (2)	<0.05	9.08	3.25–25.34	17.7 (1)	<0.05

Abbreviations: OR, odds ratio; CI, confidence interval; ORA, organizational religious activity; NORA, non-organizational religious activity; IR, intrinsic religiosity; MSPSS, multidimensional scale of perceived social support; CKD, chronic kidney disease.