SELF-EFFICACY AND COMPLIANCE IN PSYCHIATRIC OUTPATIENTS.
Contributors: Indiana University School of Nursing.
Published: 1990
Number of pages: 290
Subjects: Health Sciences, Mental Health.; Health Sciences, Nursing.
Description: The purpose of this prospective study was to determine if self-efficacy and outcome expectation would predict health behavior, attendance, and dropout of young chronic clients in psychiatric day treatment. Subjects were 43 men and 37 women who were an average of 31 years of age, who had prolonged psychiatric disorders, and who were participating in psychiatric disorders, and who were participating in psychiatric day treatment. Of these subjects, 28% had a secondary diagnosis of drug and/or alcohol abuse. Data were collected, using structured interviews and staff ratings, at three times (on admission, at 2 months, and at 3 months after admission). Instruments with multiple items were found to have adequate internal consistency reliability.

General self-efficacy, specific self-efficacy, and outcome expectation for five health behaviors were used to predict the frequency of each of the five health behaviors (coping, monitoring, treatment participation, assertiveness, and medication management), attendance in day treatment, and dropout from day treatment. Bandura's self-efficacy model was the theoretical basis for exploring relationships between health beliefs and health behavior. Relationships were explored using Pearson correlations, multiple regression, and discriminant analysis.

Bandura's model was supported for only one of the five health behaviors, medication management. Self-efficacy and outcome expectation for medication management at 2 months and general self-efficacy on admission predicted medication management at 2 months, F = 3.23, p $<$.05. Health beliefs at 2 months for the other four health behaviors and health beliefs on admission, however, failed to significantly predict health behaviors, attendance, and dropout. The strongest predictors of attendance and dropout were staff ratings of subjects' satisfaction and progress with treatment at 2 months after admission. Significant (p $<$.05) predictors of health behaviors at 2 months were staff ratings of subjects' satisfaction and progress in treatment at 2 months, functional level, and level of health behavior on admission.

As a group dropouts (n = 20) had significantly lower admission health behavior ratings and satisfaction ratings when compared with admission health behavior and satisfaction of other subjects. Dropouts also demonstrated a significant decrease in outcome expectation for participation from admission to 2-month follow-up scores. It was recommended that further study of compliance in this population include additional variables of specific skill level for the health behaviors, factors that reinforce and block performance of health behavior, and beliefs about current need and importance of attendance at treatment.
Notes: Source: Dissertation Abstracts International, Volume: 52-09, Section: B, page: 4665.

Thesis (D.N.S.)--INDIANA UNIVERSITY SCHOOL OF NURSING, 1990.

School code: 0815.