Journal of East-West Nursing Research (동서간호학연구지)

East-west Nursing Research Institute, Kyung Hee University (경희대학교 동서간호학연구소)
권호 표지
DOI QR코드

DOI QR Code

A Structural Model of Health Behavior Compliance in Patients with Percutaneous Coronary Intervention based on Self-Determination Theory

자기결정성이론 기반 관상동맥중재술 환자의 건강행위 이행 구조모형

  • Received : 2018.10.16
  • Accepted : 2018.11.10
  • Published : 2018.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to construct and test a structural equation model of health behavior compliance among patients with percutaneous coronary intervention based on self-determination theory. Methods: A total of 227 participants who received follow-up care after percutaneous coronary intervention were recruited. A structured questionnaire was used to assess health providers' autonomous support, basic psychological needs, autonomous motivation, controlled motivation, type D personality, and health behavior compliance. Collected data were analyzed using SPSS 21.0 and AMOS 21.0 program. Results: The final hypothetical model showed a good fitness with data: GFI=.94, RMSEA=.07, CFI=.96, NFI=.92, TLI=.94. The results revealed that autonomous support of health care providers, basic psychological needs, and autonomous motivation, and D-type personality accounted for 51.8% of health behavior compliance. Conclusion: The findings of this study indicate that enhanced autonomous support of health care providers is essential to promote patients' basic psychological needs and autonomous motivation. This leads to maximized compliance to the health behaviors among patients who underwent percutaneous coronary intervention. We recommend that health care institutions establish various measures to foster the special environments in which health care providers can actively provide and utilize autonomous support for their patients.

Keywords

DSKHBO_2018_v24n2_101_f0001.png 이미지

Figure 1. The conceptual framework of the study

DSKHBO_2018_v24n2_101_f0002.png 이미지

Figure 2. Path diagram for the hypothetical model

Table 1. Descriptive Statistics of Predictor Variables

DSKHBO_2018_v24n2_101_t0001.png 이미지

Table 2. Estimates and Effects of Predictor Variables in the Model

DSKHBO_2018_v24n2_101_t0002.png 이미지

References

  1. World Health Organization. United Nations high-level meeting on noncommunicable disease prevention and control: NCD summit to shape the international agenda [Internet]. New York, World Health Organization; 2015 [cited 2017 May 15]. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/
  2. Statistics Korea. 2016 annual report on the causes of death statistics [Internet]. Daejeon: Author; 2017 [cited 2017 September 20]. Available from: http://kostat.go.kr/portal/korea/kor_nw/2/6/1/index.board
  3. Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager M A, Franklin BA, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the american heart association and american college of cardiology foundation endorsed by the world heart federation and the preventive cardiovascular nurses association. Journal of the American College of Cardiology. 2011;58(23):2432-2446. http://doi.org/10.1016/j.jacc.2011.10.824
  4. Clark AM, King-Shier KM, Spaling MA, Duncan AS, Stone JA, Jaglal SB, et al. Factors influencing participation in cardiac rehabilitation programmes after referral and initial attendance: qualitative systematic review and meta-synthesis. Clinical Rehabilitation. 2013;27(10):948-959. https://doi.org/10.1177/0269215513481046
  5. Song R, June KJ, Ro YJ, Kim CG. Effects of motivation-enhancing program on health behaviors, cardiovascular risk factors, and functional status for institutionalized elderly women. Journal of Korean Academy of Nursing. 2001;31:858-70. https://doi.org/10.4040/jkan.2001.31.5.858
  6. Lee JY. A structural model for health promotion behavior and the quality of life of patients with ischemic heart disease [dissertation]. Seoul: Kyung Hee University; 2005. p. 1-154.
  7. Shin ES. A model for the compliance after percutaneous coronary intervention in patients with acute coronary syndrome [dissertation]. Gwangju: Chonnam National University; 2009. p. 1-77.
  8. Choi EH. Structural equation modeling of health behaviors in patients with coronary artery disease based on the coping model of chronic illness [dissertation]. Seoul: Seoul National University; 2012. p. 1-107.
  9. Ryan RM, Patrick H, Deci E, Williams GC. Facilitating health behaviour change and its maintenance: interventions based on self-determination theory. European Health Psychologist, 2008;10(1):2-5.
  10. Halvari H, Healey J, Olafsen AH, Byrkjeland R, Deci EL, Williams GC. Physical activity and motivational predictors of changes in health behavior and health among DM2 and CAD patients. Scandinavian Journal of Medicine & Science in Sports. 2017;27:1454-1469. https://doi.org/10.1111/sms.12757
  11. Lee EH, Park JW. A structural equation model on health behavior adherence for elders with prehypertension: based on self-determination theory. Journal of Korean Academy of Fundamentals of Nursing. 2012;19(3):343-352. https://doi.org/10.7739/jkafn.2012.19.3.343
  12. Seo YM, Choi WH. A predictive model on self care behavior for patients with type 2 diabetes: based on self-determination theory. Journal of Korean Academy Nursing. 2011;41(4):491-499. https://doi.org/10.4040/jkan.2011.41.4.491
  13. Williams GC, Gagne M, Mushlin AI, Deci EL. Motivation for behavior change in patients with chest pain. Health Education. 2005;105(4):304-321. https://doi.org/10.1108/09654280510602516
  14. Ginting H, van de Ven M, Becker E, Naring G. Type D personality is associated with health behaviors and perceived social support in individuals with coronary heart disease. Journal of Health Psychology. 2014;21(5):727-737. https://doi.org/10.1177/1359105314536750
  15. Deci EL, Ryan RM. The "what" and "why" of goal pursuits: human needs and the self-determination of behavior. Psychological Inquiry. 2000;11(4):227-268. https://doi.org/10.1207/S15327965PLI1104_01
  16. Deci EL, Ryan RM. Handbook of self-determination research. New York: University of Rochester Press; 2004. p. 1-431.
  17. Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate data analysis. 7th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2010. p. 578-581.
  18. Yu JP. The concept and understanding of structural equation modeling. Seoul: Hannarae Publishing Co.; 2012. p. 1-391.
  19. Alikari V, Zyga S. Conceptual analysis of patient compliance in treatment. Health Science Journal, 2014;8(2):179-186.
  20. Seol SY, Lee SJ, Jeong MH, Rhee JA, Choi JS, Hwang SH, et al. Cardiology; clinical outcomes of persistent smoking in patients with acute myocardial infarction who underwent percutaneous coronary intervention. The Korean Journal of Medicine. 2011;80(5):562-570.
  21. Williams GC, Grow VM, Freedman ZR, Ryan RM, Deci EL. Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology. 1996;70(1):115-126. https://doi.org/10.1037/0022-3514.70.1.115
  22. Han SY, Shin HC. Validation of the korean version of the counseling climate questionnaire. Korean Journal of Counseling. 2010;11(4):1729-1752. https://doi.org/10.15703/kjc.11.4.201012.1729
  23. Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and type D personality. Psychosomatic Medicine. 2005;67(1):89-97. https://doi.org/10.1097/01.psy.0000149256.81953.49
  24. Lim HE, Lee MS, Ko YH, Park YM, Joe SH, Kim YK, et al. Assessment of the type D personality construct in the Korean population: a validation study of the Korean DS14. Journal of Korean Medical Science. 2011;26(1):116-123. https://doi.org/10.3346/jkms.2011.26.1.116
  25. Deci EL, Ryan RM. Intrinsic motivation and self-determination in human behavior. New York, NY: Plenum Publishing Co.; 1985.
  26. Williams GC. Freedman ZR. Deci EL. Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care. 1998;21(10):1644-1651. https://doi.org/10.2337/diacare.21.10.1644
  27. Hong SH. The criteria for selecting appropriate fit indices in structural equation modeling and their rationales. Korean Journal of Clinical Psychology. 2000;19(1): 161-177.
  28. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist. 2000;55(1):68-78. https://doi.org/10.1037/0003-066X.55.1.68
  29. Seo YM. Factors influencing medication adherence in hypertensive patients. Journal of Korean Academy of Community Health Nursing. 2010;21(1):82-91. https://doi.org/10.12799/jkachn.2010.21.1.82
  30. Cha KS, Im SM, Cho OH. Mental health and quality of life by type-D personality of the patients with coronary artery disease. The Journal of the Korea Contents Association, 2013;13(5):286-294. https://doi.org/10.5392/JKCA.2013.13.05.286