Emotions and Cognitions in Consumer Health Behaviors: A Model of Hope and Control Applied to Chronic Illnesses

Abstract

This dissertation examines the effects of hope and perceptions of control on compliance and satisfaction with medical regimens recommended to patients living with a chronic illness. The present research advances a model that attempts to predict compliance health behaviors and satisfaction with health treatments by incorporating perceptions of control conceptualized using locus of control and self-efficacy, and hope as identified by appraisal theories of emotions and measured using the Herth Hope Index. The proposed model is empirically tested in the context of a lifestyle changing chronic illness: Diabetes Type II. The concept of `perceptions of control' constitutes a central component of most social cognition models and its positive effects on health have been well documented in the literature. However, in health care services, customers experience illness, pain, uncertainty, fear and mainly perceived lack of control. What happens when patients experience loss of control? Does this explain the low compliance levels that we witness today? What if patients experience loss of control, but have high levels of hope? Hope has been associated with higher medical regimen adherence and higher levels of satisfaction. People need hope and manage to have it even in the worst circumstances. In an attempt to answer these questions, the basic premise of the formulation offered here is that the emotion of hope can play an important mediating role between perceptions of control and health behavior and health service evaluation. The empirical findings of this dissertation are mainly based on cross-sectional panel survey data from 222 Diabetes Type II patients, multiple regression analyses, and structural equation procedures following mediation analysis guidelines. The data analyses results from testing three competing models about the dynamics between hope and control support the role of hope as a mediator between perceptions of control dimensions and compliance and satisfaction with the medical treatment. In particular, the results revealed that hope mediates the effects of self-efficacy and doctors health locus of control on compliance and satisfaction. It appears that individuals have higher levels of hope only to the extent that they believe they are capable of performing the actions required by their Diabetes Type II treatment, and/or that their health outcomes are under the control of powerful doctors. These two dimensions of control lead to higher levels of compliance and satisfaction with the treatment regimen through hope. The developed model contributes to transformative consumer research by assisting in solving the challenge of patient compliance with recommended health behaviors. The low levels of compliance across various medical conditions and the increasing rate of people suffering from chronic illnesses constitute pressing research concerns in consumer research. The current research enhances the understanding of compliance behaviors and satisfaction with health services by exploring two of their potential antecedents: hope and perceptions of control; and it represents a step towards enhancing consumer health and well-being.