Figures & data
Figure 1 Repertory grid process, generating constructs and rating information.
Abbreviations: Wgt, weight; Exer, exercise; ACE-I, angiotensin converting enzyme-inhibitor (ramipril); BB, beta-blocker (carvedilol); Diur, diuretic (frusemide).
Table 1 Paticipant demographics
Figure 2 Repertory grid for two participants categorized as adherent (MARS ≥ 23). Both participants (A) and (B) had MARS score = 25.
Notes: Rating of 5: elements closer to the emergent pole; rating of 1: elements closer to the implicit pole; rating of 3: suggests both poles equally apply to the element; rating of 0: neither construct applies to the element. (A) This individual held the beliefs that reducing sodium, reducing fluid and weighing related to fluid, were for the heart, were a benefit to the individual, and were important to do. Reducing fluid was also believed to help with breathing. For exercise, ACE-I, and beta-blocker, the patient held the belief that these were for the heart, a benefit to the individual, important to do, help breathing, and affect weight. The beta-blocker was believed not to affect weight. The diuretic was believed to be related to fluid, for the heart, a benefit to the individual, and important to do but was believed not to affect breathing. In summary, the beliefs this individual had about his/her heart failure management may be considered to have been: “benefit to me,” “benefit to the heart,” “important or necessary,” and “related to weight or water.” (B) This individual held the beliefs that the ACE-I and beta-blocker help the heart and that this was a direct effect. Although reducing salt and the diuretic were believed to help the heart, neither were believed to have a direct effect; yet they were believed to affect fluid. Exercise was believed to help the heart and this is a direct effect on the heart. Reducing fluid was believed to help the heart and affect fluid. Weighing was believed to be related to fluid but to have a direct effect on the heart. In summary, the beliefs this individual had about his/her heart failure management may be considered to have been: “affect the heart,” “benefit to the heart,” and “related to fluid or water.”
Abbreviations: MARS, Medication Adherence Report Scale; Dec, decreasing; Red, reducing; ACE-I, angiotensin converting enzyme-inhibitor.
Abbreviations: MARS, Medication Adherence Report Scale; Dec, decreasing; Red, reducing; ACE-I, angiotensin converting enzyme-inhibitor.
Figure 3 Repertory grid for two participants categorized as nonadherent (MARS ≤ 22). Both participants (A) and (B) had MARS score = 22.
Notes: Rating of 5: elements closer to the emergent pole; rating of 1: elements closer to the implicit pole; rating of 3: suggests both poles equally apply to the element; rating of 0: neither construct applies to the element. (A) This individual held the beliefs that the diuretic, salt, and reducing fluids were related more to losing water, affecting weight, and breathing. Exercise was aligned with ACE-I and beta-blocker, and these were believed to affect the way this person felt and to affect the heart. In summary, the beliefs this individual had about his/her heart failure management may be considered to have been: “affect the heart,” “affect me,” and the self-care activities “affecting fluid and water”. (B) This individual held the beliefs that exercise, the ACE-I, and beta-blocker were necessary, more important, and were specifically for him/her. The ACE-I and beta-blocker were believed to help with symptoms whilst exercise to be related to weight. Weighing was believed to be important or necessary and specific to the individual (score of 3 on all of these constructs). Reducing salt and reducing fluid were believed to be unimportant and less specific for this individual. It is worth noting that this participant was not taking a diuretic, and this may account for this belief about reducing salt and reducing fluid. In summary, the beliefs this individual had about his/her heart failure management may be considered to have been: “important or necessary,” with reducing fluid and decreasing salt less important for this individual.
Abbreviations: MARS, Medication Adherence Report Scale; Dec, decreasing; Red, reducing; ACE-I, angiotensin converting enzyme-inhibitor.
Abbreviations: MARS, Medication Adherence Report Scale; Dec, decreasing; Red, reducing; ACE-I, angiotensin converting enzyme-inhibitor.
Table 2 Examples of some of the individual generated constructs for the six most common themed constructs
Table 3 Comparison between levels of self-reported adherence (from dichotomized MARS score) and the generated themed constructs