HEALTH MOTIVATION: ITS COMPONENTS AND THEIR RELATIONSHIPS WITH COMPLIANCE AMONG HEMODIALYSIS PATIENTS.
AuthorOLIVAS, GUADALUPE SOTO.
Hemodialysis -- Psychological aspects.
Chronic renal failure -- Treatment -- Psychological aspects.
AdvisorKay, Margarita A.
Committee ChairAtwood, Jan R.
MetadataShow full item record
PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractThis descriptive, correlational designed study was concerned with noncompliance with therapeutic regimens, a pervasive clinical problem which is confounded with the lack of a strong link among theory, research and practice. The focus was on one of the constructs included the Reciprocal Interaction Model of Compliance Behaviors, which was derived using a modified grounded theory methodology and following various theory building prescriptions. The overall purpose was to begin to evaluate the goodness-of-fit of this empirically, qualitatively and retroductively generated explanation of compliance behaviors. The specific aims were to develop, refine and test a 6-point response, 64-item Likert-type instrument, Olivas' Health Motivation Scale - OHMS, that adequately measures the construct, Health Motivation: the force within the patient which is developed as he/she gains experience with his/her illness as a function of time. It has two major dimensions: expectations and values. Health Motivation as indexed by an expectations/values interaction was predicted to impact compliance as measured by dietary and medication measures, both objective and subjective estimates. Using trait and nomological construct perspectives, the OHMS was systematically evaluated by internal and external association criteria and therefore validity and reliability estimates, with a purposive sample of 84 heterogeneous hemodialysis patients who represented two cultures (Anglo and Hispanic), varying in gender, age and length in hemodialysis. Internal consistency reliability and trait construct validity were derived through Cronbach's alpha and principal components factor analysis. Refined OHMS Scales had alphas and thetas ranging from .58 to .89. Explained scale variance ranged from .54 to .84. Epistemic coefficients, the validity links between concept and operational measures, ranged from .76 to .94. Internal validity of the design, estimated through multiple regression, was concluded to be satisfactory. External association assessment via multiple regression produced mixed findings. Select expectations, in linear combination with select values, explained varying degrees of the variance, in select compliance measures, R² = .11 to .44. Through empirical modeling via path analysis, select subject characteristics (ethnicity, length on dialysis, age) were found to have direct or indirect relationships with compliance. Theory, research, and practice based limitations and recommendations were made from the results of the study. (Abstract shortened with permission of author.)
Degree ProgramCollege of Nursing