{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:05:25Z","timestamp":1779789925910,"version":"3.53.1"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T00:00:00Z","timestamp":1778371200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To qualitatively analyse determinants of medication adherence in Chinese patients with PO using the Integrated Theory of Health Behavior Change (ITHBC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The study was conducted as a qualitative study using. The data is systematically analysed using thematic analysis method. We followed the COREQ Checklist to ensure rigour in our study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative descriptive study, guided by the ITHBC, was conducted at a national medical center in China (November 2023\u2013June 2024). Sixteen patients with PO were purposively sampled until data saturation. Semi\u2010structured interviews were analysed using directed thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Medication adherence was conceptualized as a dynamic, self\u2010regulatory process shaped by three interconnected components: (i) Intrinsic drivers: Patients' illness perceptions, treatment beliefs and knowledge formed the cognitive and motivational foundation. (ii) External scaffold: Family support functioned as a multidimensional facilitator through instrumental, emotional, informational and financial aid. (iii) Systemic barriers: Healthcare system inefficiencies and daily routine disruptions depleted self\u2010regulatory resources. Their interplay manifested in three emergent behavioural patterns: passive compliance, active engagement, and experiential learning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Medication adherence in Chinese patients with PO arises from interactions among individual cognition, family dynamics and systemic environment. The ITHBC provides a useful framework for understanding these mechanisms. Future interventions should address patient beliefs, mobilize family support and redesign healthcare systems to reduce barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Contribution<\/jats:title>\n                    <jats:p>Sixteen patients diagnosed with primary osteoporosis participated in this qualitative study by sharing their personal experiences and perspectives through in\u2010depth interviews. Their contributions provided essential insights into the facilitators and barriers to medication adherence, directly informing the study's findings and implications for nursing practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nop2.70595","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T06:34:44Z","timestamp":1778481284000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Medication Adherence in Patients With Primary Osteoporosis in China: A Qualitative Study Guided by the Integrated Theory of Health Behavior Change"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4861-4052","authenticated-orcid":false,"given":"Donghua","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Nursing The First Affiliated Hospital, College of Medicine, Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5419-7775","authenticated-orcid":false,"given":"Ming","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery The First Affiliated Hospital, College of Medicine, Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery The First Affiliated Hospital, College of Medicine, Zhejiang University  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,10]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.2196\/24190"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010025\u201007697\u20106"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-5-26"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"issue":"387","key":"e_1_2_15_6_1","first-page":"465","article-title":"Patients' Ideas About Medicines: A Qualitative Study in a General Practice Population","volume":"44","author":"Britten N.","year":"1994","journal-title":"British Journal of General Practice"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(22)01546\u2010X"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1234\/cjn.2025.1001244"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000011.pub3"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1234\/jns.2023.24060"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.2147\/CIA.S532913"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010020\u201005507\u20109"},{"issue":"3","key":"e_1_2_15_13_1","first-page":"394","article-title":"Patients' Adherence to Osteoporosis Therapy: Exploring the Perceptions of Postmenopausal Women","volume":"54","author":"Lau E.","year":"2008","journal-title":"Canadian Family Physician"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1234\/cjn.2025.1401764"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1234\/cgp.2026.020170"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7226.50"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010016\u20103886\u2010y"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.6003"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1674\u20102591.2020.05.002"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1234\/npr.2022.1402068"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.2196\/18901"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547\u20105069.2009.01279.x"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.569092"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.2196\/54402"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.21106"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1234\/cjo.2024.1101644"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-019-00933-0"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010018\u20104759\u20103"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198\u2010022\u201006626\u20101"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.13286\/j.1001\u20105213.2024.09.01"},{"key":"e_1_2_15_32_1","unstructured":"Yuanhua M.2021.\u201cAnalysis of Related Factors of Medication Deviation During the Hospital Home Transition Period in Elderly Patients With Osteoporotic Fractures [Master's Thesis Huzhou Normal University].\u201dhttps:\/\/doi.org\/10.27946\/d.cnki.ghzsf.2021.000064."},{"key":"e_1_2_15_33_1","doi-asserted-by":"publisher","DOI":"10.1234\/jnm.2025.070621"},{"key":"e_1_2_15_34_1","doi-asserted-by":"publisher","DOI":"10.12114\/j.issn.1007\u20109572.2024.0577"},{"key":"e_1_2_15_35_1","unstructured":"Zhu A.2025.\u201cConstruction and Preliminary Application of a Social Participation Intervention Program for Patients With Early to Mid\u2010Stage Parkinson's Disease Based on the Integrated Theory of Health Behavior Change (Doctoral Dissertation). Southern Medical University.\u201dhttps:\/\/doi.org\/10.27003\/d.cnki.gojyu.2025.000."}],"container-title":["Nursing Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70595","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nop2.70595","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nop2.70595","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T09:39:35Z","timestamp":1779788375000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nop2.70595"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":34,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/nop2.70595"],"URL":"https:\/\/doi.org\/10.1002\/nop2.70595","archive":["Portico"],"relation":{},"ISSN":["2054-1058","2054-1058"],"issn-type":[{"value":"2054-1058","type":"print"},{"value":"2054-1058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70595"}}