The relationship between levels of self-esteem, health locus of control and reported compliance with therapeutic regimens in patients with essential hypertension
Meyer, Arlene P.
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The purpose of this study was to investigate the relationships between the level of self-esteem, health locus of control and reported compliance with therapeutic regimens in patients with essential hypertension. Five hypotheses were formulated to study this relationship: 1. There will be a significant positive relationship between level of self-esteem and extent of compliance with therapeutic regimen. 2. There will be a significant positive relationship between Internal Health Locus of Control (IHLC) and extent of compliance with therapeutic regimen. 3. There will be a significant negative relationship between Powerful Others' Health Locus of Control and the extent of compliance with therapeutic regimen. 4. There will be a significant negative relationship between Chance Health Locus of Control and the extent of compliance with therapeutic regimen. 5. Self-esteem will be positively correlated with IHLC. This study was conducted at two separate public health departments in the Midwest. One health department population was mainly rural while the other was suburban. Fifty participants, 25 from each health department, contributed data for the study. Of the 50, 20 were male and 30 were female. Their ages ranged from 40 to 91 with a mean age of 65.9 years. Criteria for participation included: (1) documentation of essential hypertension by health department personnel, (2) involvement in health department for less than two years, (3) documentation of three elevated blood pressure readings in the past year, (4) supervision by medical personnel for management of hypertension, and (5) self-administration of at least one medication for blood pressure control. Individuals meeting the study criteria were approached by the investigator, who explained the purpose of the study and elicited participation. Upon giving written consent, the participants were interviewed regarding their current therapeutic regimen as ordered by their physicians. They were then asked to complete two questionnaires. One was the Coopersmith Self-Esteem Inventory and the other the Wallstons' Multidimensional Health Locus of Control. The means and standard deviations for each group of measures were calculated. Pearson product-moment correlation coefficients were computed between the following: (1) self-esteem scores and health locus of control scores, (2) self-esteem scores and compliance scores, and (3) health locus of control scores and compliance scores. No statistically significant correlations were revealed between compliance and any of the selected variables: Sixty percent of the total population were compliant, with 27% of the compliant population possessing high self-esteem. Forty percent of the compliant sample were internally-oriented compared to 30% of the non-compliant group. Correlation of age with self-esteem or compliance also revealed no significant relationship. The results of this study indicated that the target population did not fit into the relationship pattern described in the literature between self-esteem and compliance with therapeutic regimens. There was a trend toward internally-oriented subjects being more compliant with their therapeutic regimens than externally-oriented subjects, but the level of the relationship did not reach statistical significance. It is suggested that in future studies more objective measures for compliance be employed and other personal and social factors related to compliance be identified.