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Symptoms as a moderator of the relationship between beliefs and behaviors among patients undergoing coronary artery bypass surgery
Descriptive
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Title
Symptoms as a moderator of the relationship between beliefs and behaviors among
patients undergoing coronary artery bypass surgery
patients undergoing coronary artery bypass surgery
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Hekler
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Eric B.
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Eric B. Hekler
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author
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Contrada
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Richard
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Advisory Committee
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Richard J Contrada
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chair
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Wilson
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G.
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Advisory Committee
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G. Terence Wilson
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internal member
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Leventhal
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Howard
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Advisory Committee
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Howard Leventhal
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internal member
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Leventhal
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Elaine
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Advisory Committee
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Elaine Leventhal
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outside member
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Rutgers University
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degree grantor
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Graduate School - New Brunswick
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theses
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DateCreated
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2008
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2008-10
Language
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English
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electronic
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application/pdf
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text/xml
Extent
viii, 97 pages
Abstract
There is growing evidence suggesting health behaviors (e.g., physical activity, medications) significantly improve health outcomes and quality of life following coronary artery bypass graft (CABG) surgery. Despite the clear benefits of these behaviors, adherence is poor and interventions designed to promote them have yielded mixed results. This dissertation, guided by Leventhal's Commonsense Model of Self-Regulation (CSM) and Bandura's Social Cognitive Theory (SCT), was a descriptive study designed to identify beliefs that might predict adherence and serve as intervention targets.
Participants were 89 CABG (M age = 65.4, 73% male, 79.8% white) surgery patients who spoke English and were free of any neurological, cognitive, or medical condition that might influence their ability to complete the study. They were interviewed prior to surgery about their CSM and SCT beliefs and their health behaviors (i.e., physical activity, medication adherence) using structured interviews. All measures exhibited factor structures that fit with a priori expectations and had acceptable reliability (αs between .67 and .91). Demographic information was gathered during the structured interviews. Medical information was gathered from medical records and aggregated to create a single cardiac risk factor index.
Results suggested that personal control and emotional cause beliefs were positively associated with physical activity, whereas medical cause beliefs were inversely associated with physical activity. In addition, the relationship between symptoms and physical activity appeared to be statistically mediated by emotional cause beliefs. With regard to SCT beliefs, negative medication outcome expectancies (NMOE) was inversely associated with medication adherence, and the relationship between medication adherence self-efficacy and medication adherence was statistically mediated by NMOE. Examination of the possible moderating influence of symptoms on beliefs suggested that both self-efficacy and bed rest outcome expectancies were associated with physical activity if an individual was symptomatic but they were not associated with physical activity if an individual was asymptomatic. Overall, results suggest that integrating the CSM with SCT provides a useful conceptual framework for understanding medication adherence and physical activity. Future research is required to evaluate the prospective, predictive utility of this framework. In addition, interventions that are tailored to patients' symptom status seem worth pursuing.
Participants were 89 CABG (M age = 65.4, 73% male, 79.8% white) surgery patients who spoke English and were free of any neurological, cognitive, or medical condition that might influence their ability to complete the study. They were interviewed prior to surgery about their CSM and SCT beliefs and their health behaviors (i.e., physical activity, medication adherence) using structured interviews. All measures exhibited factor structures that fit with a priori expectations and had acceptable reliability (αs between .67 and .91). Demographic information was gathered during the structured interviews. Medical information was gathered from medical records and aggregated to create a single cardiac risk factor index.
Results suggested that personal control and emotional cause beliefs were positively associated with physical activity, whereas medical cause beliefs were inversely associated with physical activity. In addition, the relationship between symptoms and physical activity appeared to be statistically mediated by emotional cause beliefs. With regard to SCT beliefs, negative medication outcome expectancies (NMOE) was inversely associated with medication adherence, and the relationship between medication adherence self-efficacy and medication adherence was statistically mediated by NMOE. Examination of the possible moderating influence of symptoms on beliefs suggested that both self-efficacy and bed rest outcome expectancies were associated with physical activity if an individual was symptomatic but they were not associated with physical activity if an individual was asymptomatic. Overall, results suggest that integrating the CSM with SCT provides a useful conceptual framework for understanding medication adherence and physical activity. Future research is required to evaluate the prospective, predictive utility of this framework. In addition, interventions that are tailored to patients' symptom status seem worth pursuing.
Note
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Ph.D.
Note
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Includes bibliographical references (p. 58-62).
Subject
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Topic
Psychology
Subject
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Topic
Coronary artery bypass--Patients--Psychology
Subject
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Topic
Adjustment (Psychology)
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Graduate School - New Brunswick Electronic Theses and Dissertations
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rucore19991600001
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http://hdl.rutgers.edu/1782.2/rucore10001600001.ETD.17490
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ETD_1106
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doi:10.7282/T3SF2WHZ
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ETD doctoral
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Rights
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The author owns the copyright to this work.
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Copyright protected
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Open
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Name
Eric Hekler
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Rutgers University. Graduate School - New Brunswick
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Non-exclusive ETD license
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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