Journal of Korean Academy of Fundamentals of Nursing (기본간호학회지)

Korean Academy of Fundamentals of Nursing (기본간호학회)
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A Structural Equation Model on Health Behavior Adherence for Elders with Prehypertension: Based on Self-Determination Theory

자기결정성 이론에 근거한 고혈압 전단계 노인의 건강행위이행 구조 모형

  • Received : 2012.05.18
  • Accepted : 2012.07.24
  • Published : 2012.08.31
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Abstract

Purpose: The purpose of this study was to develop and test a hypothetical model which explains health behavior adherence in elderly people with prehypertension. The model was based on self-determination theory (SDT). Methods: Data were collected from June 21 to July 15, 2010, using self-report questionnaires. The participants were 140 elders with prehypertension who lived in D Metropolitan City. Collected data were analyzed using PASW 18.0 for descriptive statistics and correlation analysis and AMOS 5.0 for covariance structure analysis. Results: It appeared that the overall fit index was good with a ${\chi}^2$ score of 13.23 (p<0.05), GFI of 0.97, AGFI of 0.79 and RMR of 0.28 in the modified model. The results revealed that significant main effects of both health provider's autonomy support and autonomous motivations were found on the measure of health behavior adherence. These factors explained 72% of variance in the participants, health behavior adherence. Conclusion: The overall findings may provide useful assistance in developing effective motivation-enhanced programs for health behavior adherence.

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References

  1. Brawley, L. R., & Culos-Reed, S. N. (2000). Studying adherence to therapeutic regimens: overview, theories, recommendations. Controlled Clinical Trials, 21, 156-163. https://doi.org/10.1016/S0197-2456(00)00073-8
  2. Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., et al. (2003). The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Journal of the American Medical Association, 289, 2560-2572. https://doi.org/10.1001/jama.289.19.2560
  3. Ciechanowski, P. S., Katon, W. J., Russo, J. E., & Walker, E. A. (2001). The patient-provider relationship: attachment theory and adherence to treatment in diabetes. The American Journal of Psychiatry, 158, 29-35. https://doi.org/10.1176/appi.ajp.158.1.29
  4. Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum Publishing Co.
  5. Deci, E. L., & Ryan, R. M. (2000). The 'what' and 'why' of goal pursuits: human needs and the self-determination of behavior. Psychological Inquiry, 11, 227-268. https://doi.org/10.1207/S15327965PLI1104_01
  6. Deci, E. L., & Ryan, R. M. (2004). Handbook of self-determination research. New York: The University of Rochester Press.
  7. Ding, L., Velicer, W. F., & Harlow, L. L. (1995). Effects of estimation methods, number indicators per factor, and improper solutions on structural equation modeling fit indices. Structural Equation Modeling: A Multidisciplinary Journal, 2, 119-144. https://doi.org/10.1080/10705519509540000
  8. Jeon, H. O. (2007). The influencing factors on self-care in the elderly essential hypertensive patients. Unpublished master's thesis, Ewha Womans University, Seoul.
  9. Kim, M. T., Hill, M. N., Bone, L. R., & Levine, D. M. (2000). Development and testing of the hill-bone compliance to high blood pressure therapy scale. Progress In Cardiovascular Nursing, 15, 90-96. https://doi.org/10.1111/j.1751-7117.2000.tb00211.x
  10. La Guardia, J. G., Ryan, R. M., Couchman, C. E., & Deci, E. L. (2000). Within-person variation in security of attachment: a self-determination theory perspective on attachment, need fulfillment, and well-being. Journal of Personality and Social Psychology, 79, 367-384. https://doi.org/10.1037/0022-3514.79.3.367
  11. Lee, H. R. (1985). A study of the effects of health contracting on compliance with health behaviors in clients with hypertension. Unpublished doctoral dissertation, Yonsei University, Seoul.
  12. Lee, S. G., & Bae, S. S. (2001). The relationship between treatment intention and compliance in newly detected hypertensive patients. Journal of Preventive Medicine and Public Health, 34, 417-426.
  13. Lee, S. M. (1990). Covariance structural analysis. Seoul: Sungwonsa.
  14. Ministry of Health & Welfare. (2011). 2010 National health statistic. Seoul: Ministry of Health & Welfare.
  15. Resnick, B. (2009). Changing and maintaining health behaviors: adherence and compliance issues. Clinical Geriatrics, 17, 38-45.
  16. Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalization: examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749-761. https://doi.org/10.1037/0022-3514.57.5.749
  17. Ryan, R. M., Patrick, H., Deci, E. L., & Williams, G. C. (2008). Facilitating health behaviour change and its maintenance: interventions based on self-determination theory. The European Health Psychologist, 10, 2-5.
  18. Schmitz, M. F., Giunta, N., Parikh, N. S., Chen, K. K., Fahs, M. C., & Gallo, W. T. (2012). The association between neighbourhood social cohesion and hypertension management strategies in older adults. Age and Ageing, 41, 388-392. https://doi.org/10.1093/ageing/afr163
  19. Seo, Y. M., & Choi, W. H. (2011). A predictive model on self care behavior for patients with type 2 diabetes: based on self-determination theory. Journal of Korean Academy of Nursing, 41, 491-499. https://doi.org/10.4040/jkan.2011.41.4.491
  20. Song, R. (2006). Analyzing motivational factors to predict health behaviors among older adults. Korean Journal of Adult Nursing, 18, 523-532.
  21. Song, R., June, K. J., Kim, C. G., & Jeon, M. Y. (2004). Comparisons of motivation, health behaviors, and functional status among elders in residential homes in Korea. Public Health Nursing, 21, 361-371. https://doi.org/10.1111/j.0737-1209.2004.21410.x
  22. Vieira, P. N., Mata, J., Silva, M. N., Coutinho, S. R., Santos, T. C., Minderico, C. S., et al (2010). Predictors of psychological well-being during behavioral obesity treatment in Women. Journal of Obesity, 10. 1155-1163.
  23. Williams, G. C., Gagne, M., Mushlin, A. I., & Deci, E. L. (2005). Motivation for behavior change in patients with chest pain. Health education, 105, 304-321. https://doi.org/10.1108/09654280510602516
  24. Williams, G. C., Grow, V. M., Freedman, Z. R., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology, 70, 115-126. https://doi.org/10.1037/0022-3514.70.1.115
  25. Williams, G. C., McGregor, H. A., Zeldman, A., Freedman, Z. R., & Deci. E. L. (2004). Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychology, 23, 58-66. https://doi.org/10.1037/0278-6133.23.1.58
  26. Williams, G. C., Patrick, H., Niemiec, C. P., Williams, L. K., Devine, G., Lafata, J. E., et al. (2009). Reducing the health risks of diabetes. The Diabetes Educator, 35, 484-492. https://doi.org/10.1177/0145721709333856
  27. Williams, G. C., Rodin, G. C., Ryan, R. M., Grolnick, W. S., & Deci, E. L. (1998). Autonomous regulation and long-term medication adherence in adult outpatients. Health Psychology, 17, 269-276. https://doi.org/10.1037/0278-6133.17.3.269
  28. Woo, K. M. (2003). Effects of exercise-motivation program for the elderly women. Unpublished doctoral dissertation, Kosin University, Busan.
  29. Zeldman, A., Ryan, R. M., & Fiscella, K. (2004). Client motivation, autonomy support and entity beliefs: Their role in methadone maintenance treatment. Journal of Social and Clinical Psychology, 23, 675-696. https://doi.org/10.1521/jscp.23.5.675.50744
  30. Zoffmann, V., & Lauritzen, T. (2006) Guided self-determination improves life skills with type 1 diabetes and A1C in randomized controlled trial. Patient Education and Counseling, 64, 78-86. https://doi.org/10.1016/j.pec.2005.11.017

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