Social support, self-esteem, and medication-taking behavior in older adults.

Abstract

The influence of perceptions of social and personal competency on medication-taking was examined in a two-group secondary analysis of older adults who had experienced a chronic heart condition. Two group structural equation modeling was used to compare the separate influences of quality of perceived emotional support from family and friends for higher and lower self-esteem groups on reported adherence of medication-taking. The influence of age, education, marital status, and gender were controlled statistically. The use of panel data supported the causal ordering specified in the model, and tested the utility of a proposed construct of maintenance, made up of self-efficacy, intention, and mastery (current adherence). Based on fit statistics, these items were tested separately, with all other items predicting adherence. Approximately 50% of the variance in adherence was explained by the model for both groups, with the greatest influence contributed by self-efficacy and intention. Significant differences were found in the relationships of the factors between the higher and lower self-esteem groups. The influence of self-efficacy on intention was significantly higher for the lower self-esteem group, and self-efficacy increased adherence significantly more for the higher self-esteem group. While perceived emotional social support had negligible direct on adherence, a modest positive effect was revealed through indirect effects. Family support tended to have greater influence on maintenance for the higher self-esteem group, while perceived emotional support from friends had a stronger influence on adherence for the lower self-esteem group. These findings point to the mechanisms through which social support influences health, specifically by bolstering feelings of self-efficacy and intention. Findings suggest that personal self-evaluation (self-esteem) has a notable influence on the way social support is utilized in maintaining a medication taking regimen. Suggestions for future research and applications for health education interventions are discussed.