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Mariam Khan, Kari E Branham, Thiran Jayasundera, Naheed W Khan; Adherence and Satisfaction in Argus II Prosthesis Users: A Self Determination Theory Model. Invest. Ophthalmol. Vis. Sci. 2020;61(7):928.
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© ARVO (1962-2015); The Authors (2016-present)
Self-determination theory (SDT) focuses on the ways a person is motivated to initiate and sustain new health related behaviors. We used SDT to examine associations among different forms of motivation, adherence to and satisfaction with the Argus II retinal prosthesis, and visual outcome measures.
Subjects were 9 Argus users, 5 males mean age 62.6±10.4 SD years and 4 females, mean age 72.75 ±7.4 SD years. Subjects completed a validated 16 item Situational Motivation Scale (SIMS) survey that measures intrinsic motivation (IM), identified regulation (IR), external regulation (ER), and amotivation (AM). A second, 20 item, Argus Satisfaction questionnaire (ASQ) was developed to measure the user’s decision to get Argus (DA), self-perception (SP) as an Argus user, utility (UA) of the Argus, perceived competence (PC) and family influence (FI). Pearson’s correlations (r) were used to find associations between measures from SIMS and ASQ. One sample t-tests for both 5-Likert scale surveys were used to assess mean significant difference from the norm (score 3). Number of active Argus electrodes and perceptual threshold (PT) to electrical stimulation of the electrodes was used as an indicator of visual outcome.
Mean duration from device programming to survey completion was 407±256 SD days. The SIMS survey mean scores were: IR 4.39±0.15 SD, IM 3.36±0.51 SD, ER 1.70±0.14 SD and AM 1.78±0.16 SD). Significant difference from norm was noted for all forms of motivation (p<0.0001) and in ASQ for DA (p<0.001), SP (p<0.002) and FI (p<0.0001). Significant correlations between forms of motivation and ASQ questions were found for: IM with SP, UA, PC (r=0.77, p<0.03); IR with DA, SP and UA (r=0.77, p<0.01), and PC (r=0.71, p<0.03); AM with UA (r=0.67, p<0.049) but not with ER. There were no correlations between any of the survey questions and duration, gender, PT, or with number of active electrodes. Older subjects did not find utility of the Argus (r=0.82, p<0.01).
Argus users demonstrated high identified regulation by identifying and internalizing the importance of using the Argus. They did not use the device to get an external reward nor were they coerced by others. While the usefulness of the Argus scored low, users did not regret the decision of getting the device. Clinicians can improve outcomes by supporting confidence in users to maintain internalization.
This is a 2020 ARVO Annual Meeting abstract.
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