The spectrum of adherence among the chronically ill: The association between the marital family system and the adherence behavior of hemodialysis patients.

Format:

Book

Thesis/Dissertation

Author/Creator:

Barsa del Alcazar, Christine Louise.

Contributor:

University of Pennsylvania.

Language:

English

Subjects (All):

Families--Research.

Families.

Sociology--Research.

Sociology.

Medicine.

Social service.

0452.

0564.

0628.

Local Subjects:

0452.

0564.

0628.

Physical Description:

181 pages

Contained In:

Dissertation Abstracts International 57-11A.

System Details:

Mode of access: World Wide Web.

text file

Summary:

Despite the availability of treatment options for many chronic illnesses, reported prevalence rates of medical noncompliance remain high. In order to determine the cause and the cure for noncompliance, prior research has often evaluated noncompliance pejoratively, implying that the "good" patient complies whereas the "bad" patient does not. Instead, this study evaluated compliance behavior along a spectrum which was subdivided to reflect increasing levels of adherence. The focus of the study was to reveal the importance of the marital/family interface on the spectrum of adherence, and to show that the moderately adherent were associated with higher degrees of marital and family functioning than the very adherent or the not adherent.

The sample was taken from an adult hemodialysis population at a NYC outpatient renal center. Biomedical data was taken directly from dialysis charts. Information regarding the patients' adherence behavior, marital satisfaction and family functioning was obtained via self-report questionnaires. The test packet included two instruments devised for the study, the Spectrum of Adherence Index (SAI) and the Illness in Family Index (IFI), marital indices derived from the Spanier Dyadic Adjustment Scale (Spanier, 1976) and the Family APGAR (Smilkstein, 1978). 111 patients completed test packets. Correlations and ANOVA's were used to determine the degree of association between the adherence scores as measured by the SAI and the scores from the marital and family indices.

The SAI had a significant correlation with the Family APGAR and a near significant correlation with IFI (i.e. the most adherent patients exhibited higher scores on the family functioning indices). Although marital indices did not reach significant degrees of association with SAI, the trend in marital scores indicated that the moderately adherent reported more satisfied marriages/relationships than the very adherent or the not adherent.

Potential marital/family dynamics which may account for the findings are presented. Implications for social work practice and social work education are discussed. Suggestions regarding the direction for future research are proposed.

Notes:

Source: Dissertation Abstracts International, Volume: 57-11, Section: A, page: 4928.

Supervisor: Louise Shoemaker.

Thesis (Ph.D.)--University of Pennsylvania, 1996.

Local Notes:

School code: 0175.

ISBN:

9780591204476

Access Restriction:

Restricted for use by site license.