{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:27:22Z","timestamp":1787218042848,"version":"build-2736575974"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oral targeted therapy is now integral to the management of older adults with hepatocellular carcinoma (HCC), yet suboptimal adherence persistently undermines its real-world effectiveness. Although the Health Belief Model (HBM) is widely applied to explain health behaviors, its integration with self-efficacy theory\u2014particularly in the HCC context, where the volitional gap between belief and action frequently dictates clinical outcomes\u2014remains inadequately characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To elucidate factors associated with oral targeted therapy adherence in elderly HCC patients and to evaluate the explanatory utility of an integrated HBM-self-efficacy framework for medication-taking behavior.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 653 older HCC patients on oral targeted agents were recruited via convenience sampling. Data were collected using demographic questionnaires, validated HBM and self-efficacy scales, and the Morisky Medication Adherence Scale (MMAS-8). Binary logistic regression and mediation analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean MMAS-8 score was 6.08 \u00b1 1.37, with 29.10% of patients classified as having poor adherence. Independent risk factors included moderate-to-severe adverse reactions, high concern beliefs, and living alone, whereas high necessity beliefs and high self-efficacy emerged as protective factors. Notably, self-efficacy partially mediated the relationship between medication beliefs and adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combined Health Belief Model and self-efficacy framework showed notable ability to explain inter-individual differences in medication adherence within this sample. Medication beliefs and self-efficacy correlated significantly with adherence, while self-efficacy carried a detectable partial indirect association between medication beliefs and adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for oncology nursing practice<\/jats:title>\n                    <jats:p>Adherence optimization extends beyond initial patient education. Nurses should implement periodic, structured assessments and tailored behavioral interventions\u2014prioritizing the reinforcement of perceived necessity, mitigation of unwarranted concerns, and cultivation of self-efficacy to sustain long-term therapeutic compliance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1826926","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T09:10:34Z","timestamp":1787217034000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring medication adherence and risk factors in elderly patients with hepatocellular carcinoma undergoing oral targeted therapy: a cross-sectional observational study"],"prefix":"10.3389","volume":"13","author":[{"given":"Hong","family":"Feng","sequence":"first","affiliation":[{"name":"Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixin","family":"Meng","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xian","family":"Li","sequence":"additional","affiliation":[{"name":"Qilu Hospital of Shandong University","place":["Jinan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1016\/j.jhep.2022.08.021","article-title":"Global burden of primary liver cancer in 2020 and predictions to 2040.","volume":"77","author":"Rumgay","year":"2022","journal-title":"J Hepatol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1418965","DOI":"10.3389\/fimmu.2024.1418965","article-title":"The current status and future of targeted-immune combination for hepatocellular 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