Patricia Miller

Fishbein's Model of Reasoned Action and Compliance Behavior of Hypertensive Patients

A causal model based on Fishbeins Model of Reasoned Action (Ajzen & Fishbein, 1980) was tested in a bypertensive population. Intention was hypothesized to affect compliance behavior of hypertensive patients directly and to mediate the effect of the other variables. Attitude, perceived beliefs of others, and motivation to comply were hypothesized to directly affect intentions and indirectly affect compliance behavior as mediated by intention. Fifty-six newly diagnosed hypertensive patients completed the variable measures 6 months after receiving outpatient instructions. Path analysis demonstrated the Fishbein Model was found sufficient for the prescriptions of diet, smoking, activity and stress, but not for medication. Findings indicated that compliance behavior was directly influenced by intention which, in turn, was influenced directly by attitude and motivation to comply and indirectly by the perceived beliefs of others mediated by motivation to comply for the prescriptions of diet, activity, smoking, and stress prescriptions. For the medication prescription, attitude and motivation to comply directly influenced regimen compliance.

Regimen compliance two years after myocardial infarction.

Two-years postinfarction, the effect of a nursing intervention at 30 days postinfarction, and intentions, attitudes, and perceived beliefs of others on regimen compliance of myocardial infarction patients was investigated. The sample was comprised of 51 patients (E = 29, C = 22) who participated in a five-phase study over 2 years. No differences were found between experimental and control groups for regimen compliance to activity, stress, and medication prescriptions. The experimental group was significantly more compliant to the diet prescription than the control group. The control group was significantly more compliant than the experimental group with cessation from smoking. Perceived beliefs of others were predictive of compliance for all regimen prescriptions at 2 years. Attitude was also predictive of compliance with the diet, smoking, and stress regimens.

Indicators of medical regimen adherence for myocardial infarction patients

This study investigated relationships between demographic and medical variables, attitudes, perceived beliefs of others, and intentions toward medical regimen adherence and actual posthospitalization regimen adherence. During hospitalization, attitudes, perceived beliefs of others, and intentions toward prescribed medical regimen were elicited from 112 persons recovering from a first time myocardial infarction (MI). Six to 9 months posthospitalization, attitudes, perceived beliefs of others, and adherence behaviors were assessed. Multiple regression analysis indicated that, during hospitalization, attitudes and perceived beliefs of others were strong indicators of intentions to adhere to the medical regimen, but they were not indicators of actual adherence posthospitalization. Posthospitalization, attitudes and perceived beliefs of others were strong indicators of actual regimen adherence. Findings indicate rehabilitation plans for the MI patient should be individualized for hospital and home and should include data on health belief variables.

Effects of cardiac rehabilitation on psychosocial functioning and life satisfaction of coronary artery disease clients.

&NA; This article details a quantitative, descriptive study that explored the effects of participation in two types of cardiac rehabilitation programs on psychosocial functioning and life satisfaction. Forty‐seven clients with coronary artery disease (CAD) were included in the study sample. Data were collected during a home visit made 6 to 8 weeks after the coronary event. All subjects completed two data collection tools: the Sickness Impact Profile (SIP), which measured clients’ psychosocial functioning, and the Quality of Life Index (QLI), which measured clients’ life satisfaction. No significant differences were found between the two treatment groups in psychosocial functioning or life satisfaction. Psychosocial functioning and life satisfaction were found to be related strongly. Further research efforts are needed to document empirically the influence of cardiac rehabilitation participation on the clients quality of life.

Development of a health attitude scale.

A tool was developed to assess attitudes of patients with cardiac disease toward performing prescribed behaviors of their medical regimen. Two groups of subjects with heart disease were used to examine validity and reliability of the Miller Attitude Scale. One group included 480 members of Mended Hearts, Inc., and the second group consisted of 35 patients diagnosed with a first myocardial infarction. The second group repeated the attitude scale six months post-hospitalization. Performance of the medical regimen by this group was verified at the six-month follow-up period. Using Spearman Rank Correlation, there was a significant relationship between attitudes and adherence behaviors for three of the five subscales. Alpha reliabilities revealed a high degree of internal consistency of scale items for all five subscales when testing both groups.A factor analysis resulted in eight factors accounting for the majority of the variance. Each of the five behaviors of the medical regimen clearly defined a factor supporting use of the Miller Attitude Scale for assessing attitudes of heart patients toward behaviors of their medical regimen.

Stressors and Stress Management 1 Month After Myocardial Infarction

&NA; Stressors and stress management behaviors reported by 52 myocardial infarction (MI) patients were identified from a content analysis of transcriptions of nurse/patient/spouse interactions that took place 30 days postinfarction. Subjects defined stress primarily in terms of distress related to appraisals of harm, loss, or threat. Stressors and stress management behaviors varied, although subjects were similar in age and occupation and were in the same phase of recovery. Most stressors related to recent myocardial infarction and pertained to thoughts and feelings more than to external events. Others, related to family and/or work, were ongoing before the MI. Stress management behaviors comprised a continuum of physical, cognitive, and verbal behaviors ranging from active to passive. Avoidance of situations, ignoring situations, expressing feelings, and thinking things through were the four major modes of stress management behaviors. Implications for rehabilitation nursing practice are identified.

Analysis of the Jalowiec Scale with cardiac patients' spouses.

The jalowiec Coping Scale was factor analyzed usign scores of spouses of 210 cardiac surgery patients. Three factors were found which agreed with the factors reported by Jalowiec. Factor I was related to Confrontive coping strategies, Factor II to Palliative strategies, and Factor III to Emotive strategies. A little over 31% of the variance was accounted for by the three factors. Alpha reliabilities were .84, .70, and .74, respectively, for the