IMPACT OF DECISIONAL CONTROL ON PATIENT SATISFACTION AND SELECTED HEALTH CARE OUTCOMES.
Contributors: University of Alabama at Birmingham.
Published: 1987
Number of pages: 117
Subjects: Health Sciences, Nursing.
Description: This experimental study investigated the impact of patient descisional control (the independent variable) on five dependent variables: satisfaction, decision-making, systolic blood pressure, diastolic blood pressure, and weight. The purpose was to determine if adults with essential hypertension, who were encouraged to exercise decisional control, would have higher satisfaction with nurses and nursing care, perceive decision-making power, and achieve controlled blood pressures and attain weight loss over a 60-day time period.

Two internal medicine clinics, each at a military hospital, were the settings. A clinical nurse specialist at each site monitored 15 control and 15 experimental patients.

The Interaction Model of Client Health Behavior (Cox, 1982) was the conceptual framework for this study. Research strategies included biweekly clinical appointments with blood pressure and weight measurements for a 60-day period, the administration of the Risser (1975) Patient Satisfaction Questionnaire, and the Roy (1977) Decision-Making Questionnaire at the end of the study period.

MANOVA statistical analysis revealed the dependent variables of satisfaction and decisional control were significantly affected by the treatment (p =.004). A step-down analysis revealed higher decisional control in the experimental group than in the control group. Repeated measures ANCOVA with the pre-intervention blood pressure and weight as covariates revealed no significant differences between groups blood pressure and weight. Significant differences were found in (a) systolic pressures due to site and site by time interactions, (b) diastolic pressures due to site and across the three time periods, and (c) weights due to site with an interaction of treatment with the time periods. Importantly, clinical changes in blood pressures at site 1 were accompanied by treatment group members perceiving greater decision-making power compared to the control group.

Recommendations include a redesign of the study with (a) a larger sample, (b) one site, (c) greater time period to ascertain if the stepped care approach versus decisional control is effective, (d) a population receiving health care from the civilian sector, (e) further exploration through pretests those personality variables which would identify management styles most appropriate to the patient, and (f) utilization of other variables identified in Cox's model.
Notes: Source: Dissertation Abstracts International, Volume: 49-04, Section: B, page: 1088.

Thesis (D.S.N.)--UNIVERSITY OF ALABAMA AT BIRMINGHAM, 1987.

School code: 0005.