Key result
An autonomy-supportive healthcare climate directly influenced self-care behaviors among young and middle-aged hypertensive patients (Goodness-of-Fit Index = 0.90, Comparative Fit Index = 0.99).
Why the study?
To explore the structural relationships of an autonomy-supportive healthcare climate, illness consequence perception, autonomy, competence, and relatedness with self-care behaviors in adult outpatients with hypertension.
Does an autonomy-supportive healthcare climate and related psychological factors influence self-care behaviors in young and middle-aged hypertensive patients?
Cross-Sectional (n=228)
Yes
Does an autonomy-supportive healthcare climate and related psychological factors influence self-care behaviors in young and middle-aged hypertensive patients?
An autonomy-supportive healthcare climate directly and indirectly improves self-care behaviors in young and middle-aged hypertensive patients by mediating autonomy, competence, and relatedness.
Answers are grounded in this paper and cite their sources.
Autonomy support was associated with better self-care in hypertension; extends SDT application but requires RCTs before practice change.
BACKGROUND: Self-determination theory (SDT) states that the self-care behaviors of patients with chronic illnesses are affected by an autonomy-supportive healthcare climate, satisfaction of autonomy, competence, and relatedness. Autonomy-supportive healthcare climate means to provide interpersonal conditions that support the person's volition, initiative, and integrity. OBJECTIVE: The aim of this study was to explore the structural relationships of an autonomy-supportive healthcare climate, as well as the perception of illness consequences, autonomy, competence, and relatedness with self-care behaviors among adult outpatients with hypertension. DESIGN: A cross-sectional survey was conducted in 2020 across three hospitals outpatient clinics in South Korea. METHODS: A questionnaire package containing instruments measuring the perception of autonomy-supportive healthcare climate, autonomy, competence, relatedness, perception of illness consequence, self-care behaviors, sociodemographic data, and disease-related characteristics among the patients. The hypothetical model was derived from the SDT. Data were analyzed to test the hypothetical model and propose the final model. RESULTS: Complete survey data was provided by 228 participants. Overall, the findings supported the hypothesized model (Goodness-of-Fit Index = 0.90 and Comparative Fit Index = 0.99). An autonomy-supportive healthcare climate and autonomy, competence, and relatedness directly influenced the self-care behaviors of adult hypertensive patients. However, the perception of illness consequences did not have a significant direct effect on self-care behavior. CONCLUSION: Improving the autonomy-supportive healthcare climate, as well as positive perception of illness consequences, autonomy, competence, and relatedness among patients positively affects self-care behavior. Thus, an authentic partnership between healthcare providers and hypertensive patients is required to enhance trust, cooperation, and adaptation, consequently improving self-care behaviors among patients. IMPACT STATEMENT: Autonomy-supportive healthcare climate was both directly and indirectly associated with self-care behavior that mediates autonomy, competence, and relatedness among young and middle-aged hypertensive patients.
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Kim et al. (2023) conducted a cross-sectional in hypertension (n=228). Autonomy-supportive healthcare climate was evaluated on Self-care behaviors. An autonomy-supportive healthcare climate directly influenced self-care behaviors among young and middle-aged hypertensive patients (Goodness-of-Fit Index = 0.90, Comparative Fit Index = 0.99).
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