RELATIONAL COMMUNICATION, INTERPERSONAL COMMUNICATION SATISFACTION, AND DIABETES SELF-EFFICACY IN NURSE-CLIENT INTERACTION.
Contributors: University of Kansas.
Published: 1995
Number of pages: 209
Subjects: Health Sciences, Nursing.; Speech Communication.; Psychology, Behavioral.
Description: The desired outcomes of any helping relationship include positive affect and behavioral changes. These outcomes are achieved in health care encounters when clients leave with the belief that they are capable of executing the treatment plan, that is, self-efficacy.

This descriptive correlational survey with a pretest-posttest design involved a convenience sample of 113 subjects with diabetes. They ranged in age from 24 to 87 years. A path analysis was conducted on the proposed model of health communication using structural equation modeling program (EQS). Instruments were factor analyzed, and reliabilities were acceptable for the new factors. Using EQS, the investigator tested validity with confirmatory factor analysis. The interpersonal communication satisfaction scale (ICSS) was the only instrument to attain an acceptable fit index for construct validity. The relational communication scale (RCS) and diabetes self-efficacy scale (DSES) did not reach acceptable goodness-of-fit indices for construct validity.

The model of health communication, with revisions based on the LaGrange Multiplier and Wald tests, achieved a level of good fit with the EQS path analysis. There were three significant direct effects between relational communication messages and interpersonal communication satisfaction. There were multiple significant direct effects between interpersonal communication satisfaction and diabetes self-efficacy. The open communication subscale significantly affected three of the four self-efficacy subscales.

Regression analysis revealed that the RCS subscales together accounted for 5.9% of the variance in the posttest diabetes self-efficacy scores after the pretest accounted for 35.4% of the variance. The RCS subscale disconfirming messages influenced the posttest diabetes self-efficacy significantly. The ICSS accounted for 6% of the variance in the posttest diabetes self-efficacy after the variance accounted for by the pretest DSES. The RCS subscales accounted for 48.8% of the variance of the ICSS closed communication variable. The RCS subscales accounted for 45.1% of the ICSS open communication variable and 22.5% of the ICSS feedback variable.

Paired t-tests between the pre- and posttest measures of diabetes self-efficacy revealed that following the teaching sessions, clients' posttest self-efficacy scores were significantly different from the pretest scores indicating that subjects' self-efficacy increased.

The findings indicate that clients who perceived the nurses' use of confirming messages as high had significantly higher communication satisfaction and change scores from pre- to posttest diabetes self-efficacy. The findings also indicate that the proposed model of health communication achieved an adequate level of fit. Understanding how and which relational communication messages positively influence clients' communication satisfaction and self-efficacy is essential. Knowing which relational messages enhance satisfaction and self-efficacy enables the nurse to assist clients with adaptive lifestyle changes related to chronic illness.
Notes: Source: Dissertation Abstracts International, Volume: 56-12, Section: B, page: 6669.

Thesis (PH.D.)--UNIVERSITY OF KANSAS, 1995.

School code: 0099.