Purpose The purpose of this study was two-fold. The first was the establishment of a reliable and valid tool, the R-USLATCon scale that reflects degrees of concordance attitudes of both patients and health care providers established during a specific patient care episode that may or may not lead to planned adherence. Secondly, the purpose was to undertake a partial tesing of a conceptual model, the patient and healthcare provider concordance model developed to specify concepts that are linked with concordance to predict adherence.
Methods The design of this study was a descriptive correlational study used to assess the R-USLATCon scale's preliminary reliability and validity. The R-USLATCon scale is the American English version of the original British scale named the Leeds Attitude Toward Concordance (LATCon) scale. Participants were patients and their healthcare providers who completed demographic surveys and two instruments: 1) the Revised US Leeds Attitude Toward Concordance (RUSLATCon) scale and 2) Mishels' Uncertainty in Illness Community (MUIS-C) scale.
Results Initial consistency reliability was supported by achieving a standardized Cronbach's Alpha = 0.88 was established for the R-USLATCon scale for patient participants (N = 201). Principal components analysis reflected three factors within the scale, namely knowledge of concordance, valuing, and patients' beliefs of medication uncertainty. Reliability was also completed for healthcare provider participants reflected in a standardized Cronbach's Alpha = 0.86 however these results are considered exploratory due to the small number of provider participation, (N = 17). Principal components analysis reflected extraction of the same three factors. The partial testing of the conceptual model, Patient and Healthcare Provider Concordance did not reveal significant findings due to threats of internal validity, specifically instrumentation and mortality.
Implications This dissertation study will assist in the building of science by exploring further the phenomenon of patient adherence based on theoretical frameworks that serve to guide the development and testing of future interventions in clinical environments.
|Advisor:||Braden, Carrie J.|
|Commitee:||Bazaldua, Oralia, Parsons, Mickey, Raynor, Theo, Reineck, Carol|
|School:||The University of Texas Health Science Center at San Antonio|
|School Location:||United States -- Texas|
|Source:||DAI-B 72/02, Dissertation Abstracts International|
|Keywords:||Concordance scale, Medication adherence, Patient centered care, Patient provider concordance, Uncertainty|
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