Poster 12: Self-Efficacy in Health Behaviors: Is There a Difference in Huntington vs Parkinson Disease?

Abstract

Background Self-efficacy is defined as individuals' perception of their ability to successfully perform certain tasks or behaviors, or more specifically, as the belief that one can carry out a behavior to achieve a desired goal related to one's health. Higher self-efficacy is correlated with better outcomes in pulmonary disease and fibromyalgia. The role of self-efficacy in disease management has not been examined in Huntington disease (HD). Hypothesis Individuals with HD have lower self-efficacy for disease self-management than those with Parkinson disease (PD), because of more severe HD clinical course. Methods Both HD and PD patients were administered the Lorig self-efficacy scale, Mini Mental State Exam (MMSE), Brief Symptom Inventory (BSI-18, psychiatric assessment), and a demographics questionnaire. Global disease severity was clinician-rated using a five-point Likert scale. Results The sample comprised 22 HD patients and 947 PD patients. The HD patients were younger (54.4 ± 13.0 vs 66.4 ± 11.0, p = 0.01), scored worse on the MMSE (24.74 ± 3.56 vs 28.06 ± 2.93, p p = 0.016). The two groups did not differ significantly in gender ratio. HD patients reported lower self-efficacy than PD patients in 2 of the 10 Lorig subscales: Ability to Obtain Disease Information (1.94 ± .75 vs 2.29 ± .69, p = 0.04) and Effective Communication with Physicians (7.35 ± 1.73 vs 8.07 ± 1.32, p = 0.03). There was not a significant difference between groups on reported psychiatric symptom severity, but there was a trend toward HD patients reporting greater depression and anxiety (53.59 ± 14.22 vs 51.34 ± 9.77, p = 0.35; 56.18 ± 14.54 vs 52.47 ± 9.74, p = 0.13). Conclusions HD patients show lower self-efficacy in certain, but not all, health behaviors. Greater degree of cognitive decline in the HD group, reflected in MMSE scores, may have played a role in perception of self-efficacy for various domains. Because self-efficacy is a modifiable factor, enhancing HD patients' self-efficacy in those targeted areas with reported deficits may improve HD outcomes.