Adherence in Cardiovascular Disease: The Role of Positive and Negative Metacognitive Worry Beliefs

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2016

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Pinto, Ronette B.

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Abstract

On a national and global scale, cardiovascular disease (CVD) poses deleterious consequences for individual mortality and morbidity, and for broader health economics. Enhancing patient adherence is crucial for secondary prevention and improving health-related quality of life (HRQoL). Health psychology research to date is characterised by limited and inconsistent findings regarding the role of worry. Specifically, research has failed to investigate the positive and negative beliefs held by individuals regarding their worry processes. The current study utilized the Metacognitive Model of Generalized Anxiety Disorder as a theoretical basis for quantitatively testing if adherence to CVD-specific recommendations, HRQoL, and engagement in health behaviours were differentially associated with positive and negative metacognitive worry beliefs. The study adopted a mixed-methods design to further qualitatively explore satisfaction with medical care, adherence barriers, facilitators, and self-reported levels of adherence. Self-report data (N = 33) were analysed using linear and logistic regressions; qualitative data from brief semi-structured telephone interviews (N = 30) were analysed through content analysis. Results indicated that metacognitive worry beliefs were only partially associated with outcomes, whereas interviews elicited other psychological variables that are potentially more salient than worry. Adherence barriers and facilitators ranged across factors pertaining to the individual, the illness, and the medical practitioner. These findings have practical implications for the development of interventions that can enhance adherence, reduce mortality and morbidity, and ultimately benefit Australia's health care system. Worry and worry beliefs are worthy of further investigation in larger, more inclusive CVD samples free from social desirability and external validity limitations.

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School of Psychology

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Thesis (B.Sc.(Hons)) -- University of Adelaide, School of Psychology, 2016

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This electronic version is made publicly available by the University of Adelaide in accordance with its open access policy for student theses. Copyright in this thesis remains with the author. This thesis may incorporate third party material which has been used by the author pursuant to Fair Dealing exceptions. If you are the author of this thesis and do not wish it to be made publicly available, or you are the owner of any included third party copyright material you wish to be removed from this electronic version, please complete the take down form located at: http://www.adelaide.edu.au/legals

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