DEVELOPING A SCALE TO MEASURE RESPONSES OF CLIENTS WITH ACTUAL OR POTENTIAL MYOCARDIAL INFARCTIONS (DENIAL, CORONARY DISEASE).
Contributors: University of Texas at Austin.
Published: 1992
Number of pages: 223
Subjects: Health Sciences, Nursing.; Psychology, Psychometrics.
Description: An assumption in Modeling and Role-Modeling theory is that meeting instinctive needs promotes growth and development across the life span (Erickson, Tomlin, & Swain, 1988). The need for object attachments is one type of need. Loss of an attachment results in the grief process with denial and shock as the first stage. For the coronary client, an acute episode of chest pain may threaten the loss of an attachment object (one's heart function). Determining a coronary client's level of denial is important data and is needed before the nurse can develop individualized interventions to facilitate the client's adaptation.

The purpose of this exploratory study was to refine and test the Robinson Self-Appraisal Inventory-Form D (RSAI-Form D), a self-administered scale designed to measure denial. A convenience sampling method was used to recruit 130 actual or potential myocardial infarction subjects, 75 years of age and younger. Each subject completed a Demographic Form and the RSAI-Form D on their second hospitalized day. The RSAI-Form D was readministered on the fourth day of hospitalization.

A coefficient alpha for the 20-item scale was.80 for both Day 2 and Day 4. Factor analysis was used to determine if the items in the RSAI-Form D measured a unidimensional construct of denial. Day 2 and Day 4 oblique rotations revealed that items loaded on four factors, but did not load on the same factors for both days; therefore, factors were identified for each day.

Statistical results revealed that there was a significant decrease in RSAI-Form D scores from the second to the fourth hospitalized day, t = 5.83, p =.00. However, a relationship between change in RSAI-Form D scores from Day 2 to Day 4 and length of stay was not established, r =.05, F(1,127) =.27, p =.60. Two predictors, number of prior hospitalizations for chest pain and whether or not the individual had sustained a myocardial infarction this admission, identified by stepwise multiple regression, explained 9.4% of the variance in the change in RSAI-Form D scores from Day 2 to Day 4 (F (2,127) = 6.55, p =.00).

These findings provided evidence of internal consistency reliability, and content, predictive, and construct validity of the RSAI-Form D Scale. Implications for nursing practice and research were discussed.
Notes: Source: Dissertation Abstracts International, Volume: 53-12, Section: B, page: 6226.

Thesis (PH.D.)--THE UNIVERSITY OF TEXAS AT AUSTIN, 1992.

School code: 0227.