Poster Presentation
Monday, November 5, 2007
10:30 AM - 11:45 AM
Monday, November 5, 2007
1:30 PM - 2:45 PM
Four Measures to Assess a Person's Readiness to Complete a Health Care Proxy
Mary Ann Jezewski, PhD, RN, FAAN, Mary Ann Meeker, DNS, RN, Deborah Finnell, DNS, RN, NPP, Yow-Wu Wu, PhD, Loralee Sessanna, DNS, RN, and Jongwon Lee, RN, MS, WHNP, PhD(c). School of Nursing, University at Buffalo, Buffalo, NY, USA
| Learning Objective #1: describe the psychometric properties of the 4 measures of the Transtheoretical Model related to health care proxy completion. |
| Learning Objective #2: describe the psychometric properties of the 4 measures of the Transtheoretical Model related to health care proxy completion. |
The purpose of this NIH funded study (DHHS/NIH NINR- R21 NR008594A) was to operationalize the four measures of the Transtheoretical Model (TTM) (stages of change, decisional balance, processes of change, self-efficacy) for health care proxy (HCP) completion, and to develop models based on the relationships between the stages of change measure and the other three measures. The first aim of the study and the focus of this poster was: 1.) To operationalize the four measures of the TTM for HCP completion and evaluate the psychometric properties of the measures.
Historically HCP completion interventions have assumed an action paradigm ignoring an individual's readiness to change behavior. The TTM provides a framework to assess an individual's readiness to change behavior and provide interventions that are matched to the stage of readiness related to HCP completion..A random sample of 566 individuals who are insured by two health insurance companies completed telephone surveys that represent the data needed to establish the construct validity of the 4 TTM measures developed in this study. The 566 usable surveys represent a 12% return rate. For aim 1, items for each of the four TTM measures were constructed and content validity established using an expert panel. Construct validity was established using Cronbach's alpha, and confirmatory factor analysis. Internal consistency for the scales represented in all four measures were above 0.90 with the exception of the Cons in the Decisional Balance scale (alpha=0.84).Exploratory and confirmatory factor analysis (CFA) provided strong evidence for two factor decisional balance scale and CFA for processes of change scale was slightly lower than the standard threshold. The outcomes of this initial study provide the investigators with reliable and valid measures to both assess the individual's stage of readiness to complete a HCP, and design stage-matched interventions focused on completing a HCP.