Breast self-examination: A test of Deci's theory of self-determination

Banks, J. Carolyn
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The purpose of this study was to evaluate the effectiveness of the Interaction Model of Client Health Behavior in selecting variables to predict a health behavior and to test relational statements from the theory of self-determination. These relational statements were: (a) perceived competence in an activity will increase the likelihood of deciding to perform the activity, and (b) a behavior that has no external reward will more likely be exhibited by a person who is intrinsically motivated. The final purpose was testing of the instruments. A random sample of addresses of women living in a southwestern city was obtained from a mail marketing firm. Survey instruments were mailed to 1,250, and 249 useable questionnaires were returned. A researcher-developed demographic sheet and six preexisting instruments were used: the Champion Knowledge Scale, the Lashley BSE Techniques Questionnaire, the Lauver BSE Scales, the Inventory of Social Supportive Behaviors, and Cox's Health Self-Determinism Index. Discriminant analysis was utilized to predict BSE performance from age, socioeconomic status, affective response to BSE, cognitive appraisal, social support, and intrinsic motivation. The variables of competence in BSE, affective response to BSE, and age explained 68% of the variance. Stepwise multiple regression was performed to examine the relationship of competence in BSE to the same independent variables. Affective response and cognitive appraisal predicted BSE competence. These variables accounted for 25% of the variance. A significant relationship was found between frequency of BSE and competence in BSE, r\sbs =.51, p <.0001. The relationship of frequency of BSE to intrinsic motivation was not statistically significant. Internal consistency was confirmed for all of the instruments except the HSDI. Factor analysis on the ISSB and the HSDI revealed item loadings different than previous studies. The Lauver BSE Scales demonstrated factor loadings consistent with previous research. Cox's model provided the structure for selecting the variables for the study of health behaviors. Deci's theory of self-determination was supported by the results of the testing of three of four hypotheses. The instrument measuring intrinsic motivation demonstrated reliability problems.

Interaction Model of Client Health Behavior, Self-determination, Personality