title: Assessing treatment motivation among patients receiving antiretroviral therapy: a multidimensional approach.
abstract: Using multidimensional scaling (MDS) analysis, this study examined how patient conceptualisations of treatment motivation compare with theoretically based assumptions used in current assessment approaches. Patients undergoing antiretroviral therapy for HIV/AIDS (n=39) rated for similarity between all possible pairings of 23 treatment descriptions, including descriptors of intrinsic, extrinsic, approach and avoidance motivation. MDS analyses revealed that patient perceptions of intrinsic and extrinsic motivations often differ from those based on definitions derived from common interpretations of self-determination theory. Findings also showed that patients reported motivation for avoiding treatment when they associated their medication regimens with side effects and other negatively valenced outcomes. The study describes new applications of MDS in assessing how patients perceive the relationship between treatment behaviours and specific forms of motivation, such as intrinsic and extrinsic motivations. In addition, the study suggests how MDS may be used to develop behavioural strategies aimed at helping patients follow their regimens consistently by identifying treatment conceptualisations and contexts that facilitate or impede adherence.
authors.affiliation: HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Department of Statistics and Education, Teachers College, Columbia University, New York, NY 10027, USA. eh2441@columbia.edu
authors.forename: Eric
authors.initials: E
authors.lastname: Houston
authors.forename: David J
authors.initials: DJ
authors.lastname: McKirnan
authors.forename: Daniel
authors.initials: D
authors.lastname: Cervone
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Johnson
authors.forename: Theo G M
authors.initials: TG
authors.lastname: Sandfort
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000517:prevention & control; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology* / Q000706:statistics & numerical data; D002641:Chicago; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000208:ethnology / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006801:Humans; D007266:Inhibition, Psychological; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000208:ethnology / Q000523:psychology / Q000706:statistics & numerical data; D011594:Psychometrics; D012923:Social Class; D011795:Surveys and Questionnaires; D016312:Treatment Refusal
chemical_list: D019380:Anti-HIV Agents