Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
Community
Ask the community for help and clear up your study doubts
Discover the best universities in your country according to Docsity users
Free resources
Download our free guides on studying techniques, anxiety management strategies, and thesis advice from Docsity tutors
The problem of the study was: When subjects with epilepsy are classified according to indicators of compliance, are there differences in the levels of unmet.
Typology: Lecture notes
1 / 123
This page cannot be seen from the preview
Don't miss anything!
The writer would like to express thanks to those individuals who were supportive during the writing of this thesis. This includes the members of my thesis committee, Dr. Rose Nieswiadomy, Dr. Oneida Hughes, and Dr. Shirley Ziegler, chairperson of the committee. Special thanks to Dr. Shirley Ziegler for her guidance in all aspects of the thesis process.
iii
Chapter I. INTRODUCTION Problem of the Study.... JustificationConceptual Framework of the Problem Assumptions. Hypotheses DefinitionLimitations of Terms Summary ... II. LITERATURE REVIEW Theories Related to Compliance Impact of Epilepsy as a Chronic Disorder.. ..
Summary .... III. PROCEDURE FOR COLLECTION AND TREATMENT OF DATA.... Setting.... PopulationProtection ofand HumanSample Subjects. Instruments... Data Collection. Treatment of Data IV. ANALYSIS OF DATA Description of the Sample v
Page
vii
1 2 2 (^38)
. • • 9 . 1521 22 23 23 34 .. 3638
Findings ... Additional Findings Summary of Findings. V. SUMMARY OF THE STUDY •
Summary. Discussion of the Findings Conclusions and Implications Recommendations for Further Study
Page
78 78
. (^8389) 89 . 91
A. Self-Actualization Inventory {modified) 93 B. Reddin Self-Actualization Inventory. 95 C. Compliance Inventory. 97 D. Solicitation of Subjects 99 E. Texas Woman's University Human Subjects Review Committee Permission to Conduct Study 103 F. Graduate School Approval Letter 106 G. Human Subjects Review Committee Permission University of Texas Southwestern. 108 H. Parkland Memorial Hospital Agency Permission to Conduct Study 110 I. Informed Consent Form 112
vi
viii
Page
. 73
Clients, diagnosed with a chronic disorder, and their families, face not only a barrage of complex medical problems but must also make important psychological, social, and economic adjustments. For some time, health care providers have recognized the impact of basic needs on the client's ability to comply with treatment regimens. Yet, little has been written on compliance in relation to the needs identified by Abraham Maslow {1968). Basic survival needs for food, water, and shelter must first be met before the client can be expected to grasp the notion that treatment compliance can offer him/her long-term benefits and possibly lead to achievement of a higher functioning lifestyle and level of wellness. If the health care industry is truly interested in moving the public towards health promotion, attention must be directed at the problems related to health maintenance. Health education for the public can do little to promote compliance if health care providers do not first recognize and address the underlying contributing factors that
1
3 of health improve the quality of life for the client, decrease the costs to the client and society, and have the potential to decrease the morbidity associated with any disease process. It is therefore imperative that nursing, as well as other health care disciplines, begin addressing those economic, psychological, and sociocultural factors that affect the individual's access to and ability to achieve a higher level of health. If a relationship between one's level of unmet needs and treatment compliance were to be determined, it might serve as the basis of generating intervention modes that could increase compliance with treatment regimens. Conceptual Framework This study was based on Maslow's motivational theory and Neuman's Health Care Systems Model. Maslow will be discussed first. Abraham Maslow (1970) is credited with the development of the humanistic theory of personality. His theory is one of motivation. Maslow identified a hierarchy or pyramid of needs ranging from the most basic to the higher levels of human functioning. Basic needs must be fulfilled if the individual is to move into the realization of his/her potential. Maslow (1970) stated,
Humanhighest life aspirations will never are be takenunderstood into account.unless its Growth, self-actualization, the striving towards health, the quest for identity and autonomy, the yearning for excellence (and other ways of phrasingaccepted (^) beyondthe striving question "upward") as a widespread must now beand perhaps universal tendency. (pp. 1.2 -13)
4
Maslow suggested that all human desires are arranged in an ascending hierarchy of priorities. His theory includes concepts of human sickness and of human health as they relate to self-fulfillment of the individual. Maslow (1970) specifically cited nine assumptions on which his theory is based.
that improving individual health is one way of making a healthier society. The Betty Neuman (1989) model provides a holistic approach to nursing interventions to assist the client to adapt to stressors in a manner that maintains his or her basic core's physiological, psychological, sociocultural, and developmental subsystems. The Neuman model sees the patient as a holistic individual interacting with his/her environment, which in turn impacts health behavior. According to Neuman, the primary goal of nursing intervention is maintenance of the client's system stability. The model considers the basic core, flexible lines of defense, normal lines of defense, and internal lines of resistance to be the major concepts. These concepts make up the framework from which nursing interventions are derived and implemented to assist the client in reconstitution (return to and maintenance of system stability following treatment of stressor reaction). The basic core of an individual is his/her very substance of being and includes those factors necessary for survival and maintenance of health/wellness. These factors are considered to be unique to the individual, but share a commonality with other human beings.
6
7 The flexible lines of defense serve as a protective mechanism against stressor penetration. The flexible lines of defense are thought of as dynamic and accordion- like, rapidly expanding away from or drawing closer to the normal lines of defense in response to stress. Neuman described the normal lines of defense as the second protective mechanism. Normal lines of defense are those behavioral responses the individual develops over a period of time that maintain a normal or usual wellness state. The normal lines of defense, like the flexible lines, can expand or contract in response to stress, but do so more slowly. The protective mechanism that lies between the basic structure and the normal lines of defense are the lines of resistance. Neuman defined lines of resistance as internal forces encountered by a stressor that act to decrease the degree of reaction. The protective mechanisms the individual engages are behavioral responses which serve to maintain a state of wellness and balance and adaptation to environmental stressors. Loss of these protective mechanisms can be caused by stressors encountered by the individual and may result in death or illness.
frequency, independent living, and gainful employment reflect, at least in part, treatment compliance. Hypotheses There are six needs (physical, security, relationship, respect, independence, and self- actualization) and six indicators of treatment compliance (maintenance of therapeutic drug levels, appointments kept, prescribed medications taken, seizure frequency, independent living, and gainful employment). Each of the six needs is analyzed for each of the six compliance indicators. (^) Thus, 36 hypotheses were generated.
9
4'. When subjects with epilepsy are classified according to frequency of seizure categories, as an indicator of compliance, there are differences in the level of unrnet physical needs.
10
13
