Causal Model of Autonomous Motivation to Modify Dietary Behavior among People with Early-stage Chronic Kidney Disease

Dietary behavior is significant for delaying chronic kidney disease progression but is difficult to modify. Autonomous motivation is one of the key concepts that seem to be useful for behavior modification. Thus, this descriptive cross-sectional study was purposed to develop and test a causal model of autonomous motivation to modify dietary behavior among people with early-stage chronic kidney disease. Participants comprised 308 people with early-stage chronic kidney disease from ten tertiary hospitals in Thailand. Data collection employed a demographic and health information form, the Regulation of Eating Behaviour Scale: Autonomous Motivation Subscale, the General Causality Orientation Scale: Autonomy Orientation Subscale, the Health Care Climate Questionnaire Short-Form, the Importance Domain of the Aspiration Index: Intrinsic Life Aspiration Subscale, the Importance Domain of the Aspiration Index: Extrinsic Life Aspiration Subscale, and the Basic Need Satisfaction in General Scale. Data were analyzed through descriptive statistics and structural equation modeling using M-plus.The results showed the final model explained 57% of the variance in autonomous motivation to modify dietary behavior. Intrinsic life aspiration, autonomy support from healthcare providers, and autonomy orientation had a positive direct effect on autonomous motivation and an indirect effect through basic psychological need satisfaction. Basic psychological need satisfaction had a positive direct effect on autonomous motivation. On the other hand, extrinsic life aspiration had neither a direct nor an indirect effect on autonomous motivation. Nurses can use these findings to design and test nursing interventions by integrating autonomy orientation, autonomy support from healthcare providers, and intrinsic life aspirations for enhancing autonomous motivation to modify the dietary behavior of this population.