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The Mediating Role of Positive and Negative Emotional Attractors between Psychosocial Correlates of Doctor-Patient Relationship and Treatment Adherence in Type 2 Diabetes

Khawaja, Masud S.
http://rave.ohiolink.edu/etdc/view?acc_num=case1283995516

Abstract Details

2011, Doctor of Philosophy, Case Western Reserve University, Organizational Behavior.
Uncontrolled diabetes leads to blindness, amputation, kidney failure, and death. Despite such severe complications, treatment adherence rate for diabetes is low. This dissertation explores a mediational model of treatment adherence in type 2 diabetics. Mediation analysis goes beyond assessing whether a predictor causes change in an outcome; it examines how that change occurs. Specifically, this research hypothesizes that a patient’s positive/negative emotional states, represented by the Lorenz attractors of Positive and Negative Emotional Attractors (PNEA), mediate the relationship between psychosocial correlates of doctor-patient relationship and treatment adherence. The study was conducted in Karachi, Pakistan. Survey respondents were 375 type 2 diabetic patients and their companions who attended follow-up clinics; and 25 physicians who examined them. Mediation analysis was performed using hierarchical linear modeling techniques to account for nested data. Bootstrapping procedure tested the significance of mediated effects. Findings confirmed the hypotheses that empathy, trust, information exchange, rapport, physicians’ PNEA and diabetes knowledge were associated with treatment adherence. Patients’ PNEA was found to completely mediate the relationships of empathy, trust, rapport and diabetes knowledge with treatment adherence. The relationships of information exchange and physician’s PNEA with that of treatment adherence were partially mediated. No association was found between treatment adherence and social support, co-morbid depression or shared decision-making. The results also demonstrated that higher levels of a patient’s Positive Emotional Attractor (PEA) were related to higher levels of treatment adherence. Overall, these findings lend support to the proposition that a patient’s emotional state plays a pivotal role in treatment adherence outcome.
Richard Boyatzis, PhD (Committee Chair)
Christopher Burant, PhD (Committee Member)
James Stoller, PhD (Committee Member)
Corinne Coen, PhD (Committee Member)
232 p.
Health Care; Health Education; Organizational Behavior; Psychology; Social Psychology
treatment adherence; treatment compliance; type 2 diabetes; positive and negative emotion; intentional change; doctor-patient relationship; physician-patient relationship; physician-patient communication; hierarchical linear model; mediation analysis

Recommended Citations

Citations

  • Khawaja, M. S. (2011). The Mediating Role of Positive and Negative Emotional Attractors between Psychosocial Correlates of Doctor-Patient Relationship and Treatment Adherence in Type 2 Diabetes [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1283995516

    APA Style (7th edition)

  • Khawaja, Masud. The Mediating Role of Positive and Negative Emotional Attractors between Psychosocial Correlates of Doctor-Patient Relationship and Treatment Adherence in Type 2 Diabetes. 2011. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1283995516.

    MLA Style (8th edition)

  • Khawaja, Masud. "The Mediating Role of Positive and Negative Emotional Attractors between Psychosocial Correlates of Doctor-Patient Relationship and Treatment Adherence in Type 2 Diabetes." Doctoral dissertation, Case Western Reserve University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=case1283995516

    Chicago Manual of Style (17th edition)

case1283995516
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This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.