Abstract
AimsSelf-efficacy is presumed important in chronic disease management; we assessed the association between self-efficacy and risk of hospitalization in adults with type-2 diabetes. MethodsA prospective cohort was assembled between December 2011 to December 2013. Participants completed an extensive survey, including a previously validated 6-item assessment of chronic disease management self-efficacy. The association between self-efficacy (low, medium, high) and all-cause hospitalization within 1 year of the survey was assessed using multivariable logistic regression, after adjustment for sociodemographic characteristics, physical, behavioral and psychosocial factors. ResultsAmong the cohort (n = 1915), the average age was 64.5 (SD 10.7) years, 45.3% were women and 199 (10.4%), 459 (24.0%) and 1257 (65.6%) participants reported low, medium and high self-efficacy, respectively. Participants with low self-efficacy were younger, had more comorbidities, and followed less healthy behaviors compared to those with high self-efficacy. In unadjusted analyses, low self-efficacy was associated with increased risk of hospitalization (23.6% vs 9.6%; odds ratio (OR) 2.90: 95% confidence interval (95%CI 1.99, 4.23)) compared to those with high self-efficacy, while no significant association was observed for medium self-efficacy level (OR 1.28: 95%CI 0.91, 1.79). After adjustment, there was no difference in hospitalization risk for participants with low (OR 0.99; 95%CI 0.59, 1.67) or medium (OR 0.67; 95%CI 0.44, 1.01) self-efficacy compared to high self-efficacy. ConclusionsOur results suggest that self-efficacy is not independently associated with lower all-cause hospitalization in this population. Focus on additional heath aspects are likely required to improve overall health outcomes in people with type-2 diabetes.
Published Version
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