Baseline Self-efficacy Scores Research Articles

The Baseline Self-Efficacy Scores to Manage Chronic Diseases Amongst Nigerian Patients with Non-Communicable Diseases are Sub-Optimal.

Nigeria is one of the developing countries with a major burden of non-communicable diseases (NCDs) without a disease self-management program in its healthcare system. Thus, this study was aimed to assess the baseline self-efficacy levels of Nigerian patients with chronic NCDs at tertiary level hospitals. This is a cross sectional study of 286 NCD patients attending tertiary level clinics from 26 July to 27 October 2023. Patients were interviewed on a 10 Self-Efficacy to Manage Chronic Disease (SEMCD) item scales that were considered suitable for the Nigerian population. The 10 SEMCD questions covered: (i) Exercise regularly scale, (ii) Help from community, family and friends scale, (iii) Communication with Physician scale, (iv) Manage disease scale and (v) Manage symptom self-efficacy domains. Data were analyzed both descriptively and statistically using Student's t-tests and Chi-square tests as appropriate. The results showed that more female (59.4%) than males (40.6%) attended clinics during the study, and the mean age of the patients did not differ between gender (P > .05). About 40% of all the patients manage their NCDs with medications alone, a trend that is similar in male and female patients (P > .05). While all the patients had a relatively lower self-efficacy scores under regular exercise scale (52%-55%) and manage disease symptoms scale (53%-55%), they tended toward higher self-efficacy scores under getting assistance from community, family, and friends (79%-80%) and communication with attending physicians (81%-85%). It is concluded that Nigeria literate NCD patients registered at tertiary level institution routine clinics are less than optimal in disease self-management care. We recommend that this study population will benefit from introduction and implementation of disease self-management program in the healthcare system.

Health Extension for Diabetes: Impact of a Community-Based Diabetes Self-Management Support Program on Older Adults' Activation.

The goals of this study were to determine whether completion of a community-based diabetes self-management support (DSMS) program delivered through a university Cooperative Extension network increased Patient Activation Measure (PAM) scores and to examine predictors of improvement in PAM score in individuals participating in the DSMS. The Health Extension for Diabetes (HED) is a 4-month program delivered via a paraprofessional extension agent in partnership with an established diabetes self-management education and support program. The study population included 148 adults (median age 69 years; interquartile range 60-74 years) with diabetes recruited from local community organizations. Data for the analysis were collected before and after participation in the intervention as part of a longitudinal study, using the PAM and Self-Efficacy for Diabetes instruments. Descriptive statistics were gathered, and hypothesis tests and simple and multivariable regression analyses were conducted. The mean PAM score increased by 6.58 points, with a 5-point change considered clinically significant. From pre- to post-intervention, PAM scores significantly decreased for 23 participants, decreased for 6, did not change for 14, increased for 21, and significantly increased for 84. Higher pre-intervention PAM scores, younger age, greater educational attainment, and higher baseline self-efficacy scores were associated with increased post-intervention PAM scores when not controlling for potential covariates. Age was no longer associated with higher PAM scores after controlling for covariates. Community-based DSMS interventions can be effective in generating positive change in individuals' activation. HED provides a feasible and accessible DSMS option that addresses key diabetes self-management components while effectively improving individuals' activation. It is recommended that people living with diabetes attend a DSMS program such as HED to increase their ability to effectively self-manage various components of their chronic condition.

Are Traditional Forms of Exercise Feasible and Acceptable for Chronic Heart Failure Patients in China? A Mixed-Method Pilot Study

Introduction Baduanjin (eight silken movements), a traditional Chinese exercise, is a promising solution to the poor uptake of cardiac rehabilitation due to low availability and unaffordability in China. The Baduanjin Eight-Silken-Movements wIth Self- Efficacy building for Heart Failure (BESMILE-HF) program is the first to apply Baduanjin in a multi-component rehabilitation program (exercise-education-evaluation-consultancy-adherence strategies). Hypothesis Assess the feasibility and acceptability of the BESMILE-HF program for chronic heart failure in China. Methods This is a mixed-method study including a pilot randomized controlled trial and semi-structured interviews. Eighteen patients with NYHA II∼III without restrictions on ejection fraction participated in this study. They were randomized into either an intervention group receiving the BESMILE-HF program plus the usual medications, or a control group receiving usual medications for 6 weeks. Feasibility included: Baduanjin intensity by comparing patients' oxygen consumption (VO2) during practice to their own peak VO2; home-based exercise related issues; potential physical (exercise capacity) and psychological (quality of life, self-efficacy) benefits. Evaluations were conducted before and after intervention. Acceptability was based on end-of-study semi-structured interviews among the intervention group. We used non-parametric tests to analysis between-group difference and spearman correlation to explore factors related to exercise times, with p≤.05. Results Cardiorespiratory data for Baduanjin showed that it was a moderate-intensity exercise for participants (43%-60% of peak VO2). The intervention group had done the required home exercises (27.5 min/day, 5.6 days/week), and total home-practice time had a significant positive correlation with baseline self-efficacy scores (r=0.83, P=0.011). Self-efficacy was significantly higher in the BESMILE-HF group than the control after 6 weeks (MD: 3.2; 95% CI 0.6 to 5.9). The decline in peak VO2 was significant in the control group (-2.6±1.8, p=0.018), but not the BESMILE-HF group (-1.2±1.2, P=0.063), without between group difference (P=0.128). Interviews showed that perceived improvement was the motivation to continue exercise, and that participants enjoyed Baduanjin and its flexibility. Conclusions Our findings suggest it is feasible and acceptable to integrate Baduanjin into cardiac rehabilitation and a full-scale trial is on-going to access its efficacy and safety.

Effects of a Nurse-Led Phone Follow-up Education Program Based on the Self-efficacy Among Patients With Cardiovascular Disease.

The integration of self-efficacy (SE) theory within a nurse-led telephone follow-up education program (NP-FEP) has not been extensively evaluated for patients with cardiovascular disease. The aim of this study is to determine the effectiveness of an NP-FEP in improving SE (primary outcome) and achieving goals related to cardiovascular risk (secondary outcome) for patients with cardiovascular disease. In June and July 2013, a total of 403 patients with cardiovascular disease in Shanghai were randomized into the intervention and control groups. Personalized end goals were established for improving cardiovascular risk for each patient. The control group received conventional follow-up education, whereas the intervention group was contacted by telephone 11 times over a 6-month period with staged goals developed based on SE theory. Self-efficacy scores and goals for reducing cardiovascular risk were assessed at baseline, at the end of the 6-month intervention, and 12 months after enrollment. The SE scores in both groups increased at 6 months and decreased slightly at 12 months. The baseline SE scores were similar between the groups (P > .05), but the average SE scores were increased more for the intervention group than for the control group at 6 (P < .05) and 12 (P < .05) months. In addition, the final goal achievement rates for the intervention group were significantly higher than for the control group (P < .05). The difference between the 2 groups was reflected by differences in cardiac disease risk factors defined by the World Health Organization. The NP-FEP improved SE and facilitated achievement of goals related to risk factors in patients with cardiovascular disease for at least 1 year.

Video Intervention to Increase Perceived Self-Efficacy for Condom Use in a Randomized Controlled Trial of Female Adolescents.

To assess the effects of the Seventeen Days interactive video on young women's perceived self-efficacy for using condoms 6months after being offered the intervention, relative to a control. Multisite randomized controlled trial. Twenty participating health clinics and county health departments in Ohio, Pennsylvania, and West Virginia. Sexually active female adolescents ages 14 to 19years. Seventeen Days (treatment intervention; sex education) vs Driving Skills for Life (control intervention; driving education). Perceived self-efficacy for condom use. Participants in the Seventeen Days group reported higher perceived condom acquisition self-efficacy after 6months than those in the driving group. This finding held after controlling for baseline self-efficacy scores and other covariates. The Seventeen Days program shows promise to improve perceived self-efficacy to acquire condoms among sexually active female adolescents-an important precursor to behavior change.

Quit Now? Quit Soon? Quit When You’re Ready? Insights About Target Quit Dates for Smoking Cessation From an Online Quit Date Tool

BackgroundSetting a target quit date (TQD) is often an important component in smoking cessation treatment, but ambiguity remains concerning the optimal timing (ie, quitting spontaneously versus delaying to prepare).ObjectiveWe examined four questions about the timing of TQDs and smoking outcomes in secondary analyses of The iQUITT Study, a randomized trial of Internet and telephone treatment for cessation: (1) What are the characteristics of TQDs set using an online interactive quit date tool?, (2) What are the characteristics of individuals who use a quit date tool and do they differ from those who do not?, (3) Are there differences in smoker characteristics, treatment utilization, and cessation outcomes based TQD timing?, and (4) Is maintenance of an initial TQD predictive of abstinence or do changes to TQDs lead to cessation?MethodsA total of 825 adult current cigarette smokers were randomized to enhanced Internet or enhanced Internet plus telephone counseling. Latency to TQD in days was calculated as the date difference between the initial TQD and enhanced Internet registration; prospective TQD setters were stratified into four latency groups (0, 1-14, 15-28, 29+ days). Baseline variables, website utilization, and 3-month cessation outcomes were examined between prospective TQD groups. Desire and confidence to quit, number of TQDs, and website logins were tested as predictors of 30-day point prevalence abstinence (ppa) at 3 months (responder-only analyses). Classification and regression tree (CART) analysis explored interactions among baseline variables, website utilization, and latency to TQD as predictors of 30-day ppa.ResultsThere were few baseline differences between individuals who used the quit date tool and those who did not. Prospective TQDs were set as follows: registration day was 17.1% (73/427), 1-14 days was 37.7% (161/427), 15-28 days was 18.5% (79/427), and 29+ days was 26.7% (114/427). Participants with a TQD within 2 weeks had higher baseline self-efficacy scores but did not differ on smoking variables. Individuals whose TQD was the same day as registration had the highest logins, page views, number of TQDs set using the tool, and messages sent to other members. Logistic regression revealed a significant interaction between number of TQDs and website logins for 30-day ppa (P=.005). Among those with high logins, 41.8% (33/79) with 1 TQD were abstinent versus 25.9% (35/135) with 2+TQDs. Logins and self-efficacy predicted 30-day ppa in the CART model.ConclusionsTQD timing did not predict cessation outcomes in standard or exploratory analyses. Self-efficacy and an apparent commitment to an initial TQD were the components most highly related to abstinence but only via interactions with website utilization. Findings highlight the importance of feeling efficacious about handling specific smoking situations and engaging with treatment. Additional research focused on increasing engagement in Web-based cessation studies is needed.Trial RegistrationClinicalTrials.gov: NCT00282009; http://clinicaltrials.gov/show/NCT00282009 (Archived by WebCite at http://www.webcitation.org/6Kt7NrXDl).

A simple clinical measure of quadriceps muscle strength identifies responders to pulmonary rehabilitation.

The aim was to determine if baseline measures can predict response to pulmonary rehabilitation in terms of six-minute walk distance (6MWD) or quality of life. Participants with COPD who attended pulmonary rehabilitation between 2010 and 2012 were recruited. Baseline measures evaluated included physical activity, quadriceps strength, comorbidities, inflammatory markers, and self-efficacy. Participants were classified as a responder with improvement in 6MWD (criteria of ≥25 m or ≥2SD) and Chronic Respiratory Questionnaire (CRQ; ≥0.5 points/question). Eighty-five participants with a mean (SD) age of 67(9) years and a mean forced expiratory volume in one second of 55(22)% were studied. Forty-nine and 19 participants were responders when using the 6MWD criteria of ≥25 m and ≥61.9 m, respectively, with forty-four participants improving in CRQ. In a regression model, responders in 6MWD (≥25 m criteria) had lower baseline quadriceps strength (P = 0.028) and higher baseline self-efficacy scores (P = 0.045). Independent predictors of 6MWD response (≥61.9 m criteria) were participants with metabolic disease (P = 0.007) and lower baseline quadriceps strength (P = 0.016). Lower baseline CRQ was the only independent predictor of CRQ response. A participant with relatively lower baseline quadriceps strength was the strongest independent predictor of 6MWD response. Metabolic disease may predict 6MWD response, but predictors of CRQ response remain unclear.

An evaluation of the psychometric properties of the Smoking Self-Efficacy Questionnaire (SEQ-12) among Chinese cardiac patients who smoke

Smoking cessation can reduce both morbidity and mortality among patients who have heart disease. China has the largest number of smokers in the world, and most smokers have low motivation to quit. Regular smoking cessation services are almost nonexistent in China, and little is known about the psychometric properties of instruments in assessing smoking self-efficacy in Chinese, whose cultures differ greatly from those of Westerners. The present study tested the psychometric properties of the Chinese version of the Smoking Self-Efficacy Questionnaire (SEQ-12) among 1,841 Chinese smokers who had heart disease, including (a) factorial structure using confirmatory factor analysis, (b) reliability with Cronbach's alpha, (c) concurrent validity, and (d) predictive validity of successful quitting. Confirmatory factor analysis of the SEQ-12 revealed a modified two-factor model that provided a good fit to the data; item 6 ("urge to smoke") was an indicator for the external stimuli subscale rather than for the internal stimuli subscale. Internal consistency coefficients (.77 for external stimuli and .88 for internal stimuli) were acceptable. Baseline self-efficacy scores were significantly associated positively with stage of readiness to quit, and negatively with cigarettes smoked per day and Fagerstrom Test for Nicotine Dependence (FTND) score. Multivariate logistic regression analysis showed that successful quitting at 1 month and at 3 months were predicted by higher external stimuli score, fewer cigarettes smoked per day, lower FTND scores, and being in the intervention group. We concluded that the Chinese version of the SEQ-12 is a valid and reliable instrument for Chinese cardiac patients who smoke. The SEQ-12 can be used to assess smokers' self-efficacy so that appropriate smoking cessation interventions can be provided.

The Moderating Effect of Self-Efficacy on Intervention Response in Women Family Caregivers of Older Adults With Dementia

This study performed moderator analyses to determine if self-efficacy predicted differential outcome in a randomized trial comparing a cognitive behavior psychoeducational intervention and an enhanced support group (ESG). The four key outcomes were depression, anxiety, social support, and coping. Low baseline self-efficacy scores were hypothesized to be more predictive of positive response in the psychoeducational intervention than in the support group. Change from pre- to posttreatment (baseline to three months) for 213 female caregivers of older adult relatives with dementia (122 Anglos and 91 Latinos) are presented. Caregivers were randomly assigned to either the coping with caregiving class (CWC), a skill-building, small group intervention designed to reduce caregiving stress, or to an enhanced support group (ESG), which used guided discussion and empathic listening to develop within-group reciprocal support. The findings showed that low baseline self-efficacy scores better predicted positive response to treatment in the CWC intervention than in the ESG intervention. This study supports the use of self-efficacy as a screening tool for appropriate caregiver intervention assignment.

Self-efficacy as a predictor of adult adjustment to sickle cell disease: one-year outcomes.

The present study prospectively investigated the role of self-efficacy in predicting disease symptomatology and health services utilization for adult patients with sickle cell disease. These data are derived from a 12-month prospective cohort study of African American adults with sickle cell disease. Disease-specific perceptions of coping self-efficacy and indices of disease severity, health care utilization, and psychosocial adjustment were assessed by use of standardized questionnaires administered by trained clinicians. Perceptions of self-efficacy for coping with sickle cell disease were moderately stable across the 12-month study period. At baseline (N = 147), significant inverse relationships, measured with Pearson correlations, were noted between self-efficacy and the following variables: physical symptoms, psychological symptoms, pain severity, and number of physician visits over the preceding 12 months (p <.01). Similar relationships with self-efficacy were noted at the 1-year follow-up (N = 104) period for measures of physical symptoms, psychological symptoms, and pain severity (p <.01). In multiple-regression models, baseline self-efficacy scores predicted changes over the 1-year study period in physical and psychological sickle cell disease symptomatology. Moreover, changes in self-efficacy from baseline to 1-year follow-up were significantly and independently related to changes in physical symptoms, psychological symptoms, and pain ratings from baseline to 1-year follow-up. Self-efficacy beliefs among African American adults with sickle cell disease are inversely related to reported disease symptomatology, and these relationships persist across time. Future investigations should examine the mechanisms through which relationships between self-efficacy and adjustment to sickle cell disease are effected, as well as the feasibility and effectiveness of enhancing self-efficacy beliefs as a means of improving adjustment to sickle cell disease.

Development and validation of a scale measuring self-efficacy of current and former smokers.

To develop and test the validity of a questionnaire measuring the confidence of current and former smokers in their ability to abstain from smoking in high-risk situations. We collected qualitative data in a first mail survey in 115 smokers and ex-smokers, and used these data to develop survey items. We collected quantitative data in a second mail survey in 529 smokers and ex-smokers to finalize the instrument. General population in Geneva, Switzerland, 1995, 1997 and 1998. The study resulted in a two-dimensional 12-item scale: the "Smoking Self-Efficacy Questionnaire" (SEQ-12). The two six-item subscales measure confidence in ability to refrain from smoking when facing internal stimuli (e.g. feeling depressed) and external stimuli (e.g. being with smokers). Internal consistency coefficients were high ("internal stimuli": alpha = 0.95; "external stimuli": alpha = 0.94). Test-retest intraclass correlation coefficients were high (0.95 and 0.93 for the two scales, respectively). In smokers, baseline self-efficacy scores predicted smoking cessation at 16-month follow-up. Finally, the scale respected criteria of content- and construct validity. SEQ-12 is a valid and reliable scale, which has applications in both research and clinical settings. It can also produce input data for computer systems that generate counselling reports tailored to the characteristics of each individual smoker.

Stages of Change, Self-Efficacy, and the Adoption of Vigorous Exercise: A Prospective Analysis

Components of the transtheoretical model of change were examined in a prospective study of the adoption of vigorous exercise in adults. Respondents to a random mail survey were resurveyed 2 years later. Those who reported no vigorous exercise at baseline were classified as either contemplators (n = 213) or precontemplators (n = 188). Contemplators had higher baseline self-efficacy scores than precontemplators (p &lt; .001). In multivariate analyses, baseline stage of change was a significant predictor (p &lt; .0005) of later adoption of vigorous exercise, even after controlling for differences in age, gender, and self-efficacy. During the first 6 months postbaseline, contemplators were nearly twice as likely as precontemplators to progress to the stage of action (46% vs. 24%), and four times more likely to progress to the stage of maintenance (25% vs. 6%). Use of the transtheoretical model in the study of exercise was supported in this prospective examination of exercise in a community sample.