Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications

The MyMAAT was developed using Exploratory Factor Analysis and the current study intends to confirm the measurement model, dimensionality and ensure the factor structure by Confirmatory Factor Analysis (CFA). A cross-sectional study was conducted using a self-report questionnaire at six health facil...

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Main Author: Tian, Ong Gaik
Format: Thesis
Language:English
Published: 2024
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Online Access:http://eprints.usm.my/61110/1/Ong%20Gaik%20Tian-E.pdf
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spelling my-usm-ep.611102024-11-11T08:17:13Z Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications 2024-03 Tian, Ong Gaik R Medicine RS1-441 Pharmacy and materia medica The MyMAAT was developed using Exploratory Factor Analysis and the current study intends to confirm the measurement model, dimensionality and ensure the factor structure by Confirmatory Factor Analysis (CFA). A cross-sectional study was conducted using a self-report questionnaire at six health facilities in the Federal Territories Kuala Lumpur and Putrajaya Health Department between May to November 2023. Participants with age≥18 years old, prescribed with one or more chronic medications for at least six months and understand English or Malay language were selected using quota sampling. There were two constructs in the MyMAAT, namely the Specific Medication-Taking Behaviour (Factor 1) with eight items and the Social-Cognitive Theory of Self-Efficacy and Social Support (Factor 2) with four items. There were 470 participants which comprised of Malay (62.7%), Chinese (24.0%) dan Indian (12.2%). Most participants had five drugs or less (81.3%). The final model for the Malay version of the MyMAAT retained the two constructs and 12 items with good fit: CFI=0.978, TLI=0.973, RMSEA=0.036(90%CI 0.001,0.067) and with good composite reliability CR=0.790 for Factor 1 and CR=0.787 for Factor 2. The factor loadings ranged from 0.413 to 0.832 with p-value<0.001 The AVE for Factor 1 was 0.664 and for Factor 2 was 0.491. There was a strong correlation (ρ=0.507, p < 0.001) between the Malay version of the MyMAAT with the Malay version of the MMAS-8 by adherence category from the data of 191 participants. The final measurement model of the English version did not achieve the minimum level of good fit to the data: CFI=0.933, TLI=0.917, RMSEA=0.073(90%CI 0.052,0.094) but had good composite reliability CR=0.802 for Factor 1 and CR=0.852 for Factor 2. The factor loadings ranged from 0.347 to 0.845. The AVE was 0.630 for Factor 1 and 0.392 for Factor 2. Fifty-two participants completed the test-retest after five to ten days from the first administration. The Malay version had moderate to excellent reliability based on ICC=0.932(95%CI:0.661,0.986) for Factor 1 whereas Factor 2 had poor to excellent reliability based on ICC=0.956(95%CI:0.325,0.997) by using the Two-Way Mixed Model and Consistency type. The English version had moderate to excellent reliability based on ICC=0.911(95%CI:0.554,0.982) for Factor 1 whereas Factor 2 had poor to excellent reliability based on ICC=0.941(95%CI:0.092,0.996). It can be concluded that the Malay version of the MyMAAT is valid and reliable in measuring medication adherence among participants with chronic medication(s), but the English version needs to be improved and then re-tested 2024-03 Thesis http://eprints.usm.my/61110/ http://eprints.usm.my/61110/1/Ong%20Gaik%20Tian-E.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic R Medicine
RS1-441 Pharmacy and materia medica
spellingShingle R Medicine
RS1-441 Pharmacy and materia medica
Tian, Ong Gaik
Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications
description The MyMAAT was developed using Exploratory Factor Analysis and the current study intends to confirm the measurement model, dimensionality and ensure the factor structure by Confirmatory Factor Analysis (CFA). A cross-sectional study was conducted using a self-report questionnaire at six health facilities in the Federal Territories Kuala Lumpur and Putrajaya Health Department between May to November 2023. Participants with age≥18 years old, prescribed with one or more chronic medications for at least six months and understand English or Malay language were selected using quota sampling. There were two constructs in the MyMAAT, namely the Specific Medication-Taking Behaviour (Factor 1) with eight items and the Social-Cognitive Theory of Self-Efficacy and Social Support (Factor 2) with four items. There were 470 participants which comprised of Malay (62.7%), Chinese (24.0%) dan Indian (12.2%). Most participants had five drugs or less (81.3%). The final model for the Malay version of the MyMAAT retained the two constructs and 12 items with good fit: CFI=0.978, TLI=0.973, RMSEA=0.036(90%CI 0.001,0.067) and with good composite reliability CR=0.790 for Factor 1 and CR=0.787 for Factor 2. The factor loadings ranged from 0.413 to 0.832 with p-value<0.001 The AVE for Factor 1 was 0.664 and for Factor 2 was 0.491. There was a strong correlation (ρ=0.507, p < 0.001) between the Malay version of the MyMAAT with the Malay version of the MMAS-8 by adherence category from the data of 191 participants. The final measurement model of the English version did not achieve the minimum level of good fit to the data: CFI=0.933, TLI=0.917, RMSEA=0.073(90%CI 0.052,0.094) but had good composite reliability CR=0.802 for Factor 1 and CR=0.852 for Factor 2. The factor loadings ranged from 0.347 to 0.845. The AVE was 0.630 for Factor 1 and 0.392 for Factor 2. Fifty-two participants completed the test-retest after five to ten days from the first administration. The Malay version had moderate to excellent reliability based on ICC=0.932(95%CI:0.661,0.986) for Factor 1 whereas Factor 2 had poor to excellent reliability based on ICC=0.956(95%CI:0.325,0.997) by using the Two-Way Mixed Model and Consistency type. The English version had moderate to excellent reliability based on ICC=0.911(95%CI:0.554,0.982) for Factor 1 whereas Factor 2 had poor to excellent reliability based on ICC=0.941(95%CI:0.092,0.996). It can be concluded that the Malay version of the MyMAAT is valid and reliable in measuring medication adherence among participants with chronic medication(s), but the English version needs to be improved and then re-tested
format Thesis
qualification_level Master's degree
author Tian, Ong Gaik
author_facet Tian, Ong Gaik
author_sort Tian, Ong Gaik
title Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications
title_short Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications
title_full Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications
title_fullStr Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications
title_full_unstemmed Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications
title_sort confirmatory factor analysis of the malaysia medication adherence assessment tool (mymaat) among patients with chronic medications
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2024
url http://eprints.usm.my/61110/1/Ong%20Gaik%20Tian-E.pdf
_version_ 1818647374892892160