Resilience, Motivational Factors, and Medication Adherence Among Rural Older Adults

Abstract

Adherence to hypertension medications has been explored in previous studies; however, these studies focused on individuals who reside in urban areas. More information regarding demographic characteristics and relationships to motivational factors among rural older adults with hypertension is needed. The purpose of this study was to explore medication adherence among rural older adults with hypertension and constructs identified in self-determination theory (SDT) including motivation (autonomous versus controlled), perceived competence, perceived autonomy support and basic needs satisfaction. Rural nursing theory (RNT) was used to include the concept of resilience. This cross-sectional study included a sample of 80 older adults (≥ 65 years of age) prescribed at least one medication to control hypertension. Participants ranged in age from 65 to 89 (M=74.04, SD=6.18) from rural communities in the northwest. A demographic questionnaire, a measure of medication adherence and questionnaires to assess perceived autonomy support, basic needs satisfaction, autonomous and controlled motivation, perceived competence, and resilience were used. Correlational analysis and multiple regression were used to examine associations with adherence and to predict adherence. Perceived autonomy support, resilience, cost of medication and medication regimen complexity were the only variables significantly associated with medication adherence and predicted antihypertensive medication adherence. Overall, the measure used to assess medication adherence indicated high levels of adherence.