Developing a Scale to Measure Responses of Clients with Actual or Potential Myocardial Infarctions
Review TypeNone: Degree-based Submission
Review StatusNot Applicable (See Review Type)
Repository Posting Date2019-12-03T15:35:58Z
Author(s)Robinson, Karen Rae
Author DetailsDr. Karen R. Robinson, PhD, FAAN
Lead Author Sigma AffliationXi Kappa at-Large
Level of EvidenceOther
Research ApproachQuantitative Research
CINAHL HeadingsAngina Pectoris; Cardiac Patients; Denial (Psychology); Instrument Validation; Angina Pectoris--Psychosocial Factors
An assumption in Modeling and Role-Modeling theory is that meeting instinctive needs promotes growth and development across the life span (Erickson, Tomlin, & Swain, 1988). The need for object attachments is one type of need. Loss of an attachment results in the grief process with denial and shock as the first stage. For the coronary client, an acute episode of chest pain may threaten the loss of an attachment object (one's heart function). Determining a coronary client's level of denial is important data and is needed before the nurse can develop individualized interventions to facilitate the client's adaptation. The purpose of this exploratory study was to refine and test the Robinson Self-Appraisal Inventory-Form D (RSAI-Form D), a self-administered scale designed to measure denial. A convenience sampling method was used to recruit 130 actual or potential myocardial infarction subjects, 75 years of age and younger. Each subject completed a Demographic Form and the RSAI-Form D on their second hospitalized day. The RSAI-Form D was readministered on the fourth day of hospitalization. A coefficient alpha for the 20-item scale was.80 for both Day 2 and Day 4. Factor analysis was used to determine if the items in the RSAI-Form D measured a unidimensional construct of denial. Day 2 and Day 4 oblique rotations revealed that items loaded on four factors, but did not load on the same factors for both days; therefore, factors were identified for each day. Statistical results revealed that there was a significant decrease in RSAI-Form D scores from the second to the fourth hospitalized day, t = 5.83, p =.00. However, a relationship between change in RSAI-Form D scores from Day 2 to Day 4 and length of stay was not established, r =.05, F(1,127) =.27, p =.60. Two predictors, number of prior hospitalizations for chest pain and whether or not the individual had sustained a myocardial infarction this admission, identified by stepwise multiple regression, explained 9.4% of the variance in the change in RSAI-Form D scores from Day 2 to Day 4 (F (2,127) = 6.55, p =.00). These findings provided evidence of internal consistency reliability, and content, predictive, and construct validity of the RSAI-Form D Scale. Implications for nursing practice and research were discussed.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9309268; ProQuest document ID: 304038433. The author still retains copyright.
Degree GrantorThe University of Texas at Austin
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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