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A PATH ANALYSIS OF TRUST IN NURSES, SOCIAL SUPPORT, PATIENT SELF-ADVOCACY, PSYCHOLOGICAL DISTRESS, AND PHYSICAL SYMPTOMS IN PATIENTS WITH CHRONIC HEART FAILURE

Kleman, Carolyn Cable
http://orcid.org/0000-0002-0268-5520
http://rave.ohiolink.edu/etdc/view?acc_num=kent150513325871688

Abstract Details

2017, PHD, Kent State University, College of Nursing.
A PATH ANALYSIS OF TRUST IN NURSES, SOCIAL SUPPORT, PATIENT SELF-ADVOCACY, PSYCHOLOGICAL DISTRESS, AND PHYSICAL SYMPTOMS IN PATIENTS WITH CHRONIC HEART FAILURE (199 pp.) Director of Dissertation: Ratchneewan Ross, Ph.D., RN, FAAN Patients with heart failure participate in care by self-advocating, or speaking up, to their health care providers. By gaining and using health information, assertively communicating, and making decisions, patients are self-advocating. A cross-sectional, path analysis design was used to test two structural models. A convenience sample of 80 HF clinic patients were surveyed using the Adapted Patient Self-Advocacy Scale, Health Care Relational Trust in Clinic Nurses Scale, Medical Outcome Study Social Support Scale, Hospital Anxiety and Depression Scale, and the Symptom Status Questionnaire for Heart Failure. An analysis was conducted to test the direct and indirect effects of trust in nurses, social support, and self-advocacy, on psychological distress and physical symptoms. Two structural models were created; neither model fit the data as hypothesized. A respecified model focusing on the components of self-advocacy was tested, trimmed, and found to fit the data (chi square 9.452, df 6, p .105; RMSEA .085; CFI .877, IFI .892, NFI .752). Trust in nurses directly affected patient self-advocacy knowledge (beta .25, R2 .06, p .05). Social support directly affected patient assertiveness (beta .26, R2 .07, p .05). And social support directly affected depressive symptoms (beta-.40, R2 .16, p .001). Nursing plays a role in patient self-advocacy. Educating and encouraging patients to use acquired knowledge in decision making supports patient participation and self-advocacy. Nursing’s encouragement of the supportive role of friends and family members can have a positive influence on patient assertiveness and depressive symptoms.
Ratchneewan Ross, Ph.D., R.N., F.A.A.N. (Committee Chair)
Patricia Vermeersch, Ph.D., C.N.P., R.N. (Committee Member)
Marlene Huff, Ph.D., M.S.N., C.N.S. (Committee Member)
Joel Hughes, Ph.D. (Committee Member)
Richard Adams, Ph.D. (Committee Member)
199 p.
Communication; Nursing
trust in nurses; trust in provider; social support; depression; patient self-advocacy; self-advocacy; heart failure; patient role; patient work; chronic illness; path analysis; patient participation; health promoting behaviors; patient communication

Recommended Citations

Citations

  • Kleman, C. C. (2017). A PATH ANALYSIS OF TRUST IN NURSES, SOCIAL SUPPORT, PATIENT SELF-ADVOCACY, PSYCHOLOGICAL DISTRESS, AND PHYSICAL SYMPTOMS IN PATIENTS WITH CHRONIC HEART FAILURE [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=kent150513325871688

    APA Style (7th edition)

  • Kleman, Carolyn. A PATH ANALYSIS OF TRUST IN NURSES, SOCIAL SUPPORT, PATIENT SELF-ADVOCACY, PSYCHOLOGICAL DISTRESS, AND PHYSICAL SYMPTOMS IN PATIENTS WITH CHRONIC HEART FAILURE. 2017. Kent State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=kent150513325871688.

    MLA Style (8th edition)

  • Kleman, Carolyn. "A PATH ANALYSIS OF TRUST IN NURSES, SOCIAL SUPPORT, PATIENT SELF-ADVOCACY, PSYCHOLOGICAL DISTRESS, AND PHYSICAL SYMPTOMS IN PATIENTS WITH CHRONIC HEART FAILURE." Doctoral dissertation, Kent State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=kent150513325871688

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Kent State University and OhioLINK.