Dissertation
Components of medication management: psychometric properties of the cognitive screen for medication self-management (CSMS) test in older adults
Doctor of Philosophy (Ph.D.), Drexel University
27 Apr 2007
DOI:
https://doi.org/10.17918/etd-1556
Abstract
The Cognitive Screening for Medication Self-Management (CSMS) was developed to assess the sensory and cognitive constructs associated with medication adherence. It consists of various simulated tasks, designed to measure aspects of a medication regimen. Tasks include bottle opening, label reading and telling time. In addition, it uses hypothetical medication taking regimens to assess prospective memory, encoding, recall, mental calculations, and executive/organizational strategies. This study has several aims. First, it outlined the specific psychomotor, sensory and cognitive constructs involved in understanding and executing a medication regimen. Second, it integrated previous medication adherence research and pilot studies using the CSMS in evaluating aspects of content, construct, and criterion validity. Third, using performance data of the CSMS scales from 60 older adults ranging in age from 72-95, the discriminant and convergent construct validity of the CSMS scales was examined by a principal components analysis of the factor structure using a five-factor solution. While the first two components were cognitive in nature, the third was comprised of both cognitive and non-cognitive elements. The remaining components identified two distinct sensory components involving sensorimotor and visuosensory abilities. Correlational analysis of CSMS performance scores with MMSE performance scores supported convergent relationships with global cognitive functioning on tasks of retrospective and prospective memory, calculations, dose planning and processing speed, while discriminant relationships with tasks involving clock reading, bottle opening and label reading were demonstrated. To further examine the construct validity, a number of subject group comparisons, using performance data from the CSMS scales were analyzed using univariate oneway ANOVAs to examine the effects of age and cognitive status on the medication taking tasks. Cognitive status influenced performance on all the cognitive tasks except calculations. Also, it did not influence clock reading or sensorimotor ability. Age influenced only two medication tasks which involved processing speed and prospective memory performance. Lastly, this study examined the reliability (in terms of internal consistency), item difficulty and made recommendations for improving ecological validity.
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Details
- Title
- Components of medication management
- Creators
- Darren Michael Caffery - DU
- Contributors
- Mary Spiers (Advisor) - Drexel University (1970-)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 1556; 991014632529704721