How-To Guides

Perceived benefits and perceived barriers were the health belief model factors most strongly linked to treatment adherence. Patients who believed treatment would help were more likely to be adherent, while patients who perceived more obstacles were less likely to follow treatment. In group comparisons, perceived benefit was significantly associated with compliance (P=.003) and perceived barriers showed a significant inverse association (P=.007). In regression analyses, perceived benefit remained a significant positive predictor of treatment compliance (β=0.295, P=.001), and perceived barriers showed a significant negative association (β=-1.633, P=.015).

No. In this study, perceived severity and perceived susceptibility were not significantly associated with treatment compliance among patients with dissociative disorders. The compliant and noncompliant groups had equal distributions for both constructs, with P=1.0 for perceived severity and P=1.0 for perceived susceptibility.

No, cues to action were not significantly associated with treatment adherence. Although more adherent participants reported high cues to action, the difference was not statistically significant (P=.216). The authors therefore did not identify cues to action as a direct predictor of compliance in this sample.

Yes. Active treatment engagement was strongly associated with higher adherence. Among participants currently in therapy, 55 of 83 (66.26%) were in the high-adherence group, and among those taking medication, 61 of 106 (57.54%) showed higher adherence; both associations were statistically significant (P<.001 for both).

No sociodemographic variable showed a significant association with treatment adherence in this study. Age (P=.366), sex (P=.415), marital status (P=.514), education level (P=.197), occupational status (P=.571), type of employment (P=.437), and duration of diagnosis (P=.189) were all nonsignificant. The findings suggest that beliefs about treatment and current treatment engagement were more informative than demographic characteristics for understanding adherence.

The study included 130 patients with dissociative disorders recruited from both outpatient and inpatient psychiatric settings. It used a stratified random sample drawn from the psychiatric outpatient department and inpatient ward of a large public-sector teaching hospital in Faisalabad, Pakistan. Data were collected over 4 months, from July 1 to October 31, 2024.

This was a cross-sectional study using structured interviews and a validated health belief model questionnaire. The investigators measured 5 health belief model constructs as continuous scores: perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and cues to action. They analyzed associations with treatment adherence using correlation analyses and regression methods, including stepwise logistic regression to identify independent predictors while controlling for potential confounders such as age, sex, socioeconomic status, and duration of illness.

The main limitations were the cross-sectional design, self-reported adherence, and single-center setting. Because the study was cross-sectional, it cannot establish causality. Adherence was based on self-report, which may be affected by recall bias or fluctuating insight, and the study did not assess culturally specific barriers such as stigma, family beliefs, or reliance on alternative healing practices. The absence of qualitative data also limited deeper understanding of why patients perceived certain benefits or barriers, and the single-center setting may reduce generalizability.

The findings suggest clinicians should focus less on demographic profiling and more on whether patients believe treatment will help and what barriers are preventing follow-through. The authors state that clinicians should assess beliefs about treatment usefulness and obstacles such as stigma, cost, side effects, and access to care. They also note that strengthening perceived benefits through psychoeducation, motivational interviewing, and therapeutic alliance building, while reducing perceived barriers through practical support and continuity of care, may improve adherence.