{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:35:46Z","timestamp":1790908546271,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T00:00:00Z","timestamp":1745625600000},"content-version":"vor","delay-in-days":56,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Tyrosine kinase inhibitors (TKIs) improve chronic myeloid leukemia (CML) outcomes dramatically. However, limited research exists on patient\u2010specific, medical, and psychosocial factors influencing TKI adherence. The purpose of the study was to better understand TKI adherence among rural CML patients, using a convergent parallel mixed\u2010method design guided by the Information Motivation and Behavioral Skills Model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Survivors with CML participated in semistructured interviews and completed self\u2010reported questionnaires, including demographics, perceived stress, side effects, emotional support, and self\u2010efficacy for managing chronic conditions. Qualitative and quantitative data were collected concurrently, analyzed separately, and then integrated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen participants aged 26 to 76 years completed the study. The duration of TKI therapy ranged from 0 to 12 years (mean \u00b1 standard deviation, 5.56 \u00b1 4.08). While all reported adherence to TKI therapy, 31% held misconceptions about treatment duration, and 38% misunderstood reasons for blood tests prior to treatment or TKI refilled. Qualitative data yielded five major themes with descriptions of the shock of diagnosis, educational experiences regarding CML and its treatment, challenges in managing side effects and refills, the importance of social support, and strategies for maintaining remission and motivating adherence to TKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study describes the knowledge, motivations, challenges, and skills related to TKI adherence among rural patients with CML. A patient\u2010centered approach is recommended for health care providers to improve adherence and enhance outcomes for CML patients on TKI therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70028","type":"journal-article","created":{"date-parts":[[2025,4,26]],"date-time":"2025-04-26T03:06:12Z","timestamp":1745636772000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Living with chronic myelogenous leukemia in rural communities: Exploring factors related to tyrosine kinase inhibitors adherence with a mixed methods approach"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0911-2423","authenticated-orcid":false,"given":"Jingxi","family":"Sheng","sequence":"first","affiliation":[{"name":"School of Nursing University of Wisconsin\u2010Madison Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue P.","family":"Heiney","sequence":"additional","affiliation":[{"name":"Biobehavioral and Nursing Science Department College of Nursing University of South Carolina Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen E.","family":"Wickersham","sequence":"additional","affiliation":[{"name":"Biobehavioral and Nursing Science Department College of Nursing University of South Carolina Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan A.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Biobehavioral and Nursing Science Department College of Nursing University of South Carolina Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kartina W.","family":"Harrison","sequence":"additional","affiliation":[{"name":"Biobehavioral and Nursing Science Department College of Nursing University of South Carolina Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5779-6802","authenticated-orcid":false,"given":"Swann Arp","family":"Adams","sequence":"additional","affiliation":[{"name":"Biobehavioral and Nursing Science Department College of Nursing University of South Carolina Columbia South Carolina USA"},{"name":"Department of Epidemiology &amp; Biostatistics Arnold School of Public Health University of South Carolina Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.46747\/cfp.6807515"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/coc.0000000000000700"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6614a1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32073"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2023.41.16_suppl.7055"},{"key":"e_1_2_8_7_1","unstructured":"WinsteadE.Strategy may prevent tumor resistance to targeted cancer therapies. 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