Doctoral Dissertations

Date of Award


Degree Type


Degree Name

Doctor of Philosophy


Social Work

Major Professor

Cindy L. Davis

Committee Members

Lawrence Brown, Sam Choi, Sherry Cummings, William Nugent


Accurate medication adherence and the self-efficacy to properly adhere are essential for breast cancer survivors. Not only are these patients often continuing their treatment with adjuvant therapies, they are frequently taking medications for other medical, or comorbid, issues such as diabetes, asthma, high blood pressure, arthritis, and congestive heart failure. With the increasing number of breast cancer survivors (ACS, 2009), there is a growing need for empirical research of their medication usage and the influence that health literacy has on proper adherence.

Inadequate medication adherence, lack of perceived self-efficacy in proper adherence, and low health literacy are factors that have received minimal attention with respect to breast cancer survivors, particularly those who are underserved with comorbid health issues. It would be beneficial to address these issues within a collaborative framework that addresses the multiple factors affecting them. The merits of the collaborative model of healthcare are in stark contrast to the medical model, indicating the need to use the former with breast cancer survivors.

An underlying assumption of this dissertation is that traditional medical treatment of breast cancer is the preferred and primary course of action chosen by breast cancer patients. This course is not globally accepted, and even those choosing a traditional medical route are adding complementary and alternative medicine to their treatment (Boon et al, 2000; Lee, Lin, Wrensch, Adler, & Eisenberg, 2000; Richardson, Sanders, Palmer, Greisinger, & Singletary, 2000). For the purposes of this paper, however, it is assumed that the majority of those diagnosed with breast cancer choose traditional medical courses of treatment.

This dissertation reports the exploration of the impact of a skills development intervention on medication adherence and self-efficacy. Chapter 1 provides a statement of the problem that was examined, the purpose of the study, and the objectives of the research. Chapters 2 through 5 present a review of the literature that relates to the multiple components of the study’s framework. Chapter 6 contains methodology, chapter 7 reports the results chapter 8 provides discussion of the findings, and Chapter 9 offers the conclusion and personal thoughts of the researcher.

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