Paper
Wednesday, 19 July 2006
This presentation is part of : Strategies for Care of the Chronically Ill
The Influence of Self-Concept Perceptions of Health Regimes on Adherence in Adults with Heart Failure
Christine Thomas, RN, DNSc, Department of Nursing, West Chester University, West Chester, PA, USA
Learning Objective #1: Discuss the development of the Cognitive Perception of Cardiovascular Healthy Lifestyles instrument to measure cognitive strategies in adherence as defined by Roy’s Self-concept Mode.
Learning Objective #2: Identify which aspects of threat and challenge to self-concept significantly impact adherence to recommended heart failure health regimes.
Purpose: using Roy’s Self-concept Mode Theory, examine the relationships between components of self-concept (body sensation, body image, self-consistency, self-ideal, and moral-ethical-spiritual self) and adherence to health regimes in adults with heart failure (HF).  In addition, examine the extent to which self-concept cognitive perception of health regimes predict adherence.

Methodology:

Setting: 2 outpatient cardiology clinics

Sample: convenience sample of 97 adults with HF

Design: correlational

Instruments: Data were collected using a demographic questionnaire, HF Screening test (HFST), Cognitive Perception of Cardiovascular Healthy Lifestyles instrument (CPCHL), and Adherence Questionnaire (AQ).  The instruments were based on Roy’s Self-concept Mode Theory and AHA HF treatment guidelines.  All instruments were valid (CVI .97).  Alpha coefficients ranged from .46 on the AQ to .84 on the CPCHL.

Procedures: The sample was collected during office visits.  Upon verbal consent subjects completed the questionnaires and returned them in sealed envelopes.  Findings: subjects’ were more challenged than threatened by health regimes.  Subjects reported high adherence to medications and diet, and low adherence to exercise.  Weak to moderate inverse relationships between adherence and four threat to self-concept variables were found.  Threat to overall self-concept accounted for 12% of the variance in adherence. Stepwise regression indicated that threat to body image accounted for 14%.  Weak to moderate positive relationships existed between adherence and all 5 challenge to self-concept areas.  Challenge to overall self-concept accounted for 13% of the variance in adherence. Challenge to moral-ethical-spiritual self accounted for 10.8% of the variance, and the combination of challenge moral-ethical-spiritual self and body image accounted for 14.5%.
Conclusions: the study supported the use of Roy’s Self-concept Mode Theory to investigate relationships between self-concept perception of health regimes and adherence.  This study provides a foundation for nurses to explore interventions that influence the decision-making processes to adhere to recommended regimes.

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