title: The influence of self-concept on adherence to recommended health regimens in adults with heart failure.
abstract: BACKGROUND
  Lifestyle behaviors are the largest contributors to health status. Healthy People 2010 objectives identify that a better understanding of the determinants of adherence to health regimens is needed. Psychological influences on adherence behaviors have not been fully explored in individuals with heart failure (HF).
  
  
  OBJECTIVE
  This study sought to gain understanding of the influence of self-concept on adherence to prescribed regimens in individuals with HF. Roy's Self-concept Mode Theory was used to examine the relationships between components of self-concept to recommended health regimens in individuals with HF. The study also examined the extent to which aspects of self-concept cognitive perception of health regimens might predict adherence to health regimens.
  
  
  METHODS
  A convenience sample of 97 adults diagnosed with HF was collected from 2 large HF clinics. Three instruments were pilot tested for validity and reliability. Alpha coefficients ranged from .46 on the Adherence Questionnaire to .84 on the Cognitive Perception of Cardiovascular Healthy Lifestyles instrument.
  
  
  RESULTS
  Overall subjects were more challenged than threatened by health regimens and reported high adherence to medications and diet. Inverse relationships were found between adherence and threat to body sensation, self-ideal, body sensation, and self-consistency. Overall threat to self-concept accounted for 12% of the variance in adherence. Threat to body image accounted for 14% of the variance in adherence. Positive relationships were found between adherence and challenge to body sensation, body image, self-consistency, self-ideal, and moral-ethical-spiritual self. Overall challenge to self-concept accounted for 13% of the variance in adherence. Challenge to moral-ethical-spiritual self accounted for 10.8% of the variance, and the combination of challenge moral-ethical-spiritual self and body image accounted for 14.5% of the variance in adherence.
  
  
  CONCLUSIONS
  The efficacy of recommended treatment regimens depends on how well clients adhere to them. Nurses need to identify methods that support feelings of challenge to body sensation, body image, self-consistency, self-ideal, and moral-ethical-spiritual self and minimize threat to body sensation, self-ideal, body sensation, and self-consistency to enhance adherence to health regimens in individuals with HF.
authors.affiliation: Department of Nursing, West Chester University, West Chester, PA 19383, USA. cthomas@wcupa.edu
authors.forename: Christine M
authors.initials: CM
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001828:Body Image; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009014:Morals; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D011582:Psychological Theory; D012044:Regression Analysis; D040242:Risk Reduction Behavior; D012649:Self Concept; D029181:Spirituality