Chronic Disease Self-Efficacy Scale Research Articles

Impact of Nursing Interventions Based on Self-Efficacy Theory on HAMA and HAMD Scores in Patients with Hepatitis B Cirrhosis

Objective: To explore the effect of nursing interventions based on self-efficacy theory guidance on psychological stress indicators in patients with hepatitis B cirrhosis. Methods: 70 patients with hepatitis B cirrhosis from October 2023 to May 2024 were selected and grouped by random number table. The observation group received nursing intervention based on self-efficacy theory, while the control group received routine nursing. The differences in psychological stress indicators, self-efficacy indicators, and nursing satisfaction were compared between the two groups. Results: Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scores of the observation group were significantly lower than those of the control group (P < 0.05); Chronic Disease Self-Efficacy Scale (CDSES) scores of the observation group were significantly higher than those of the control group (P < 0.05); and nursing satisfaction scores of the observation group were significantly higher than those of the control group (P < 0.05). Conclusion: Hepatitis B cirrhosis patients receiving nursing care based on self-efficacy theory can stimulate patients’ self-efficacy, calm their emotions, and their overall satisfaction is high.

P19: Effects of a Post-diagnostic Support Programme on self-efficacy among persons with dementia and family members

Background:Persons newly diagnosed with dementia and their family member is imperative often experience uncertainty and inadequate support. This study aims to evaluate a post-diagnostic support programme guided by the 5 Pillars Model proposed by Alzheimer Scotland on the self-efficacy among persons with early dementia and their family members.Methods:A prospective cohort study design was conducted between 2019 and 2022. Subject recruitment was conducted in four non-government organizations. A multi-domain empowerment programme, covering various aspects about dementia knowledge, management skills, peer support, future decision-making and community resources, was developed. The programme was provided to people newly diagnosed of early dementia in small group format over 2 months and to family members individually through an eLearning platform over 9 months. Self efficacy in dementia management of people with dementia and their family members were measured using Chronic Disease Self-efficacy Scale and Caregiver Self-efficacy Scale (CSES), respectively, whereas caregiving burden was measured using Zarit Burden Interview (ZBI). Study outcomes were measured at baseline, immediate and 6-month post-intervention. Paired t-tests were performed to detect within-subject changes over time.Results:A total of 151 persons with early dementia and 294 family caregivers completed assessment at baseline and follow up. Self-efficacy in dementia management reported by persons with dementia at 6-month post-intervention was significantly higher than that reported at baseline (p = .021) and immediate post-intervention (i.e. 2-month follow up) (p = .006). Family members reported a significantly higher CSES score (p < .001) and subscale scores in thoughts (p = .001) and disruptive behaviour management (p = .001) at 9-month follow up, but significant reduction in caregiving burden (p < .001) was only noted among those who perceived higher burden than the local norms at baseline (ZBI score ≥ 25, n = 110).Discussion:This study provides empirical evidence that post-diagnostic support would empower persons with early dementia and their family members on adapting the impacts brought by dementia. Further study on examining the longer term effects on care outcomes and health service utilisation would be valuable.

Factors related to self-management behavior among persons with mild-to-moderate chronic obstructive pulmonary disease in Wenzhou, China

Abstract Objective To describe the self-management (SM) behavior among persons with mild-to-moderate chronic obstructive pulmonary disease (COPD), and it examines the correlation between COPD knowledge, self-efficacy, perceived social support, and SM behavior among persons with mild-to-moderate COPD in Wenzhou, China. Methods A simple random sampling technique was used to recruit 121 persons with mild-to-moderate COPD who visited the respiratory outpatient department of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou, China. Research instruments include a demographic data questionnaire, COPD SM scale, COPD knowledge questionnaire, 6-item chronic disease self-efficacy scale, and perceived social support scale. Descriptive statistics and Pearson’s Correlation were used for data analysis. Results The findings show that the mean score of COPD SM scale was 2.70 (SD = 0.45). The Pearson correlation analysis revealed that the COPD knowledge (r = 0.47, P < 0.001), self-efficacy (r = 0.28, P = 0.001), and perceived social support (r = 0.48, P < 0.001) were positively correlated to the COPD SM behavior among persons with mild-to-moderate COPD in Wenzhou, China. Conclusions The findings indicate that disease knowledge, self-efficacy, and perceived social support were related to SM behavior in persons with mild-to-moderate COPD, which provides a theoretical basis for developing SM interventions for persons with mild-to-moderate COPD and improving this population’s SM behavior.

Chronic disease self-efficacy and factors influencing this in patients with ischemic stroke.

Patients' self-efficacy levels are significantly associated with the process of recovery and creating social support in the inpatient recovery setting can help prevent post-stroke depression and anxiety. To explore the current status of factors influencing chronic disease self-efficacy in patients with ischemic stroke, to provide theoretical basis and clinical data for implementing corresponding nursing interventions. The study included 277 patients with ischemic stroke who were hospitalized in the neurology department of a tertiary hospital in Fuyang, Anhui Province, China from January to May 2021. Participants for the study were selected by convenience sampling method. A questionnaire for general information developed by the researcher and the Chronic Disease Self-Efficacy Scale were used for collecting data. The patients' total self-efficacy score was (36.79 ± 10.89), which was in the middle to the upper level. Results of our multifactorial analysis showed that history of falls in the previous 12 months, presence of physical dysfunction, and cognitive impairment were all independent risk factors for chronic disease self-efficacy in patients with ischemic stroke (P< 0.05). Chronic disease self-efficacy in patients with ischemic stroke was at an intermediate to high level. History of falls in the previous year, physical dysfunction, and cognitive impairment were factors influencing patients' chronic disease self-efficacy.

Spanish version of the Self-Care of Chronic Illness Inventory: A validation study amongst community-dwelling older adults with chronic multimorbidity.

To psychometrically assess the Spanish version of the Self-Care of Chronic Illness Inventory (SC-CII-Sp) in community-dwelling older adults with chronic multimorbidity. A methodological study. A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC-CII-Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC-CII-Sp and their scores on the Spanish Chronic Disease Self-Efficacy scale (SCD-SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC-CII-Sp's reliability was tested by computing the Cronbach's alpha. The SC-CII-Sp showed good content and convergent validity. The CFA showed that the SC-CII-Sp has three sub-scales. The 8-item Self-Care Maintenance sub-scale has good internal consistency and is comprised of two dimensions: illness-related and health-promoting behaviour. The Self-Care Monitoring sub-scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6-item Self-Care Management sub-scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour. The Spanish version of SC-CII is a valid and reliable instrument to be used in the assessment of self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity. Nurses need valid and reliable tools to assess self-care behaviours in Spanish-speaking community-dwelling older adults with chronic multimorbidity. This study provides a 19-item tool that allows for the comprehensive evaluation of self-care behaviours in healthy and ill states. Using the SC-CII-Sp in clinical or research settings could help nurses to examine the effects of different interventions on self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity. None to be reported.

Symptom burden of patients with breast cancer on adjuvant hormone therapy: A preliminary report.

e12536 Background: Breast cancer (BCa) is the most common cancer in women. Adjuvant hormone therapy (AHT) showed consistent improvements in recurrence and survival rates. AHT use is associated with multiple side effects that cause a lack of adherence. This report aims to describe the symptom burden of BCA patients at treatment initiation from our ongoing RCT, which is directed at improving adherence through the innovative use of smart pill bottles. Methods: Descriptive statistics included socio-demographic information and medication use. Symptom burden and distress are assessed using the breast cancer prevention trial (BCPT) symptom scales. Self-efficacy is assessed using a modified version of Lorig’s Chronic Disease Self-Efficacy Scale for managing symptoms. Results are summarized as means (M), standard deviation (SD), ranges (R), and percentages. The relationship between patients’ symptoms and self-efficacy was analyzed using a multivariable linear regression model controlling for age and race. Results: Of the 119 patients included, the majority were White 80.7 %, with ages ranging from 31-81 with a mean age of 59.74 (SD=11.057). The majority had a college education or higher (61.3 %), married (66.4%), full-time workers (42.9 %) and had incomes of 75,000 USD or higher (59.0 %). The patients were on either Tamoxifen (17.7%), Anastrozole (55.4%), Letrozole (12.3%) or Exemestane (4.6 %). The (BCPT) subscales were; vasomotor symptoms (R=0-12.5, M= 5.8, SD= 3.14), Gastrointestinal symptoms (R=0-7.5, M= 2.97, SD= 1.14), bladder control (R=0-10, M= 3.09, SD= 1.87), Dyspareunia subscale (R=0-10, M= 3.53, SD= 2.27), Musculoskeletal pain (R=0-15, M= 7.5, SD= 3.53), Weight concerns (R=0-10, M= 4.22, SD= 2.16), Cognitive symptoms (R=0-15, M= 6.02, SD= 2.81). For the LORIG scales (R=1- 8.83, M= 6.04, SD=1.61). Patient symptoms were inversely correlated with higher LORIG scores for vasomotor symptoms (β = -.18, t(3) = -2.00, p= .048), Gastrointestinal symptoms (β = -.27, t(3) = -2.92, p= 0.004), Musculoskeletal pain (β = -.378, t(3) = -4.31, p= .000), Weight concerns (β = -.286, t(3) = -3.26, p= .0002), Cognitive symptoms (β = -.34, t(3) = -3.841, p= .000). Conclusions: Our results explore symptom burden and distress for breast cancer patients on AET. Based on the BCPT instrument subscales, musculoskeletal symptoms tend to be the most intrusive, with the highest mean score. Symptom burden was inversely related to higher self-efficacy represented by LORIG scores. This needs to be validated with further analysis in comparison to a control group across time points in the study to determine what would be a minimally important difference or change in score. This will help understand the interrelationships between physical symptoms and adherence to AHT. Clinical trial information: NCT04086875 .

Effect of Educational Intervention Program on Self-Efficacy of Individuals with Type 2 Diabetes Mellitus in South-East, Nigeria.

Diabetes Mellitus is a chronic disease, which requires a level of confidence among the sufferers in its management. This study investigated the effect of an educational intervention program on self-efficacy (SE) in diabetic individuals with type 2 diabetes mellitus in South-East, Nigeria. The study was a quasi-experimental controlled study, comprising 382 individuals with type 2 DM selected, and assigned to intervention (IG) and control groups (CG). The instrument for data collection was the Stanford Chronic Disease Self-Efficacy Scale (SCDS). Pretest data were collected, and thereafter education on diabetes management was given to the IG group. The IG was followed up for 6 months. At the end of 6 months, post-test data were collected using the same instrument. Data were analyzed using Pearson Chi-square test statistics. A P-value less than .05 alpha level was considered significant. There was no statistically significant difference between the two groups before intervention. However, after 6 months of intervention, a significant proportion of participants' scores in IG moved from low to either moderate, or high SE in almost all the SE domains (P < .05. There was an improvement in most domains of self-efficacy in the intervention group after 6 months of educational intervention.

Integrating Palliative Care Into Self-management of Breast Cancer: A Pilot Randomized Controlled Trial.

Breast cancer patients may not be well-informed about palliative care, hindering its integration into cancer self-management. The aim of this study was to test Managing Cancer Care: A Personal Guide (MCC-PT), an intervention to improve palliative care literacy and cancer self-management. This was a single-blind pilot randomized controlled trial to evaluate the feasibility/acceptability and intervention effects of MCC-PT on palliative care literacy, self-management behaviors/emotions, and moderation by demographic/clinical characteristics. We enrolled 71 stages I to IV breast cancer patients aged at least 21 years, with >6-month prognosis at an academic cancer center. Patients were randomized to MCC-PT (n = 32) versus symptom management education as attention-control (n = 39). At baseline, 1 month, and 3 months, participants completed the Knowledge of Care Options Test (primary outcome), Control Preferences Scale, Goals of Care Form, Medical Communication Competence Scale, Measurement of Transitions in Cancer Scale, Chronic Disease Self-efficacy Scale, Hospital Anxiety and Depression Scale, and the Mishel Uncertainty in Illness Scale. Mean participant age was 51.5 years (range, 28-74 years); 53.5% were racial/ethnic minority patients, and 40.8% had stage III/IV cancer. After adjusting for race/ethnicity, MCC-PT users improved their palliative care literacy with a large effect size (partial η2 = 0.13). Patients at late stage of disease showed increased self-management (partial η2 = 0.05) and reduced anxiety (partial η2 = 0.05) and depression (partial η2 = 0.07) with medium effect sizes. Managing Cancer Care: A Personal Guide is feasible and appears most effective in late-stage cancer. Research is needed to elucidate relationships among cancer stage, race/ethnicity, and self-management outcomes. Integration of palliative care into cancer care can assist in creation of appropriate self-management plans and improve emotional outcomes.

Frailty and Quality of Life among Older Adults in Communities: The Mediation Effects of Daily Physical Activity and Healthy Life Self-Efficacy.

As the global population ages, frailty, which has been shown to affect and predict the quality of life (QoL) of older adults, has become a central issue. The aim of this study was to explore the mediating effects of daily physical activity (DPA) and healthy life self-efficacy (HLSE) on the relationship between frailty and QoL in older adults using a serial multiple mediation model. The cross-sectional study was conducted among 210 community-dwelling older adults in Taiwan. Data were collected using the Taiwanese version of the Tilburg Frailty Indicator, the EuroQoL visual analog scale, the Kihon Checklist, and the Chronic Disease Self-Efficacy Scales. The PROCESS macro for SPSS based on the bootstrap method was used to determine the mediating effects of DPA and HLSE on the relationship between frailty and QoL. The results showed that frailty was found to have both direct and indirect effects on QoL. As predicted, DPA and HLSE partially mediated the relationship between frailty and quality of life (DPA: B = -0.71, p &lt; 0.001; HLSE: B = -0.32, p &lt; 0.001). In addition, serial mediation analyses indicated that the association between frailty and QoL was partially mediated by DPA and HLSE in a sequential manner (B = -0.16, p &lt; 0.001). The serial mediation has a causal chain linking DPA and HLSE, with a specified direction of causal flow. According to the results of the serial multiple mediation model, the elderly should be encouraged to continue their activities in daily life, which not only improves self-efficacy and confidence in maintaining health but also reduces the negative impact of frailty on QoL.

Factors influencing patient delay in individuals with obstructive sleep apnoea: a study based on an integrated model

Background Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder, yet it remains undiagnosed in a large proportion of adults. Objective This study aims to investigate the status of patient delay and provider delay in OSA patients and examine related factors affecting patient delay in OSA individuals in China. Methods A cross-sectional design was conducted on a sample of 309 OSA patients (aged from 18 to 76, median age of 47 years, 84.8% male) in Northeast China. Participants were required to complete the sociodemographic questionnaire, the symptom characteristics questionnaire, the help-seeking attitude scale (HSAS), the social support rating scale and the chronic disease self-efficacy scales (CDSES) to test the hypothesis. Binary logistic regression analysis was conducted to explore factors that account for the patient delay. Results The median patient delay among OAS patients in this study was 22 months, the median provider delay was one month, and the median total delay was 26 months. As shown by multivariate analysis results, patients who have snored for over 6 years (OR = 3.377, 95%CI: 1.175–9.702) were more likely to experience prolonged patient delays. Per capita monthly family income above 3000 RMB (OR = 0.172, 95%CI: 0.052–0.571), taking up residence in cities or towns (OR = 0.484, 95%CI: 0.248–0.946), higher self-recognition of the disease (OR = 0.793, 95%CI: 0.647–0.972), higher objective support (OR = 0.825, 95%CI: 0.739–0.921) and stronger self-efficacy (OR = 0.674, 95%CI: 0.525–0.867) were significantly associated with shorter patient delays. Conclusion Patient delay is common in Chinese OSA patients. The upstream factors affecting the patient delay in individuals with OSA include income, place of residence, and objective support; midstream factors include self-recognition of the disease and self-efficacy; downstream factors include years of snoring. KEY MESSAGES Despite being a high-prevalence disease, many obstructive sleep apnoea (OSA) patients are not clearly diagnosed and treated. The factors affecting the delay in seeking medical treatment in individuals with OSA included income, place of residence, objective support, self-recognition of the disease, self-efficacy and years of snoring. Investigations into OSA patients’ care-seeking behaviours can better reflect the secondary prevention of OSA, and it is crucial to pay attention to the delayed phase of patients.

Relationship between patient activation and self-efficacy among patients undergoing hemodialysis: a cross-sectional study

BackgroundPatient activation in chronic kidney disease (CKD) is increasingly being prioritized and considered a quality metric in CKD. Given the importance of patients’ activation in improving the quality of chronic disease care, this study aimed to assess patients’ activation levels and its relationship with self-efficacy among patients undergoing hemodialysis.MethodsIn this cross-sectional study, a total of 180 patients undergoing maintenance hemodialysis were selected by random sampling from the largest hemodialysis center (dialysis center of Emam Reza hospital, Tabriz) in Iran. Data were collected by demographics, patient activation measure, and chronic kidney disease self-efficacy (CKD-SE) scale from March to May 2021. Collected data were analyzed using SPSS software (ver. 26) using ANOVA, t-test, Pearson correlation coefficient, and multiple regression tests.ResultsThe majority of the participants (35%) were at level 1 of activation and only 28.9% of the individuals were at level 4. According to the results, the mean score of self-efficacy in patients undergoing hemodialysis (in a possible range of 0–10) was 5.50 ± 1.45. Multiple regression analysis showed that factors including self-efficacy, educational level, and marital status were significant predictors of change in patient activation (R2 = 0.85, adjusted R2 = 0.66, p < 0.001). The results showed that self-efficacy was the main predictor of patient activation (β = 0.49, p < 0.001).ConclusionAccording to the result, improving the patients' self-efficacy could improve the patient's activation. Moreover, patients with lower educational level reported the lower activation score; therefore, health care providers should improve the knowledge of patients with lower educational level, encourage them to be more active in their health care, and help them in providing more tailored strategies to improve the quality of care more efficiently. Furthermore, Measuring patients' activation level at admission to the dialysis unit is recommended for all patients undergoing hemodialysis.

An eHealth self-management intervention for adults with chronic kidney disease, My Kidneys My Health: a mixed-methods study.

Background:There is limited research of electronic tools for self-management for patients with chronic kidney disease (CKD). We sought to evaluate participant engagement, perceived self-efficacy and website usage in a preliminary evaluation of My Kidneys My Health, a patient-facing eHealth tool in Canada.Methods:We conducted an explanatory sequential mixed-methods study of adults with CKD who were not on kidney replacement therapy and who had access to My Kidneys My Health for 8 weeks. Outcomes included acceptance (measured by the Technology Acceptance Model), self-efficacy (measured by the Chronic Disease Self-Efficacy Scale [CDSES]) and website usage patterns (captured using Google Analytics). We analyzed participant interviews using qualitative content analysis.Results:Twenty-nine participants with CKD completed baseline questionnaires, of whom 22 completed end-of-study questionnaires; data saturation was achieved with 15 telephone interviews. Acceptance was high, with more than 70% of participants agreeing or strongly agreeing that the website was easy to use and useful. Of the 22 who completed end-of-study questionnaires, 18 (82%) indicated they would recommend its use to others and 16 (73%) stated they would use the website in the future. Average scores for website satisfaction and look and feel were 7.7 (standard deviation [SD] 2.0) and 8.2 (SD 2.0) out of 10, respectively. The CDSES indicated that participants gained an increase in CKD information. Interviewed participants reported that the website offered valuable information and interactive tools for patients with early or newly diagnosed CKD, or for those experiencing changes in health status. Popular website pages and interactive features included Food and Diet, What is CKD, My Question List and the Depression Screener.Interpretation:Participants indicated that the My Kidneys My Health website provided accessible content and tools that may improve self-efficacy and support in CKD self-management. Further evaluation of the website’s effectiveness in supporting self-management among a larger, more heterogenous population is warranted.

Determinants of self-efficacy in patients with Parkinson's disease.

Self-efficacy is the individual's assessment of his or hers ability to complete a specific task successfully and has been closely related to self-management and quality of life in several diseases. To investigate self-efficacy in a population of Parkinson's disease (PD) patients in Mexico and study the factors that are associated with this measure. We carried out a cross-sectional observational study involving patients with PD in an outpatient neurology clinic in Mexico, using the following instruments: Spanish version of the Chronic Disease Self-Efficacy Scale (CDSES), Quality of Life Questionnaire PDQ-8, Movement Disorders Society-Unified Parkinson's disease Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment (MoCA), and Non-Motor Symptom Scale (NMSS). Clinical and demographic variables were also recorded. We included 73 patients with a mean age of 65 years and most patients were male. Patients with lower CDSES scores (<7.75) had worse scores in MDS-UPDRS, NMSS, and PDQ-8 scales. CDSES scores were significantly correlated with MDS-UPDRS Part I (r=-0.497, p=<0.001), Part II (r= -0.271, p=0.020), Part III (r=-0.304, p=<0.001), PDQ-8 (r=-0.472, p=<0.001), and NMSS (r=-0.504, p=<0.001). Furthermore, when assessing the simultaneous effect of covariates associated with CDSES score, only Mood/Apathy domain of NMSS was significant (beta= -0.446, t= -3.807, p= 0.012). PD patients with lower self-efficacy scores had worse motor and non-motor symptomatology and quality of life. Mood/Apathy disorders were negatively associated with self-efficacy and contributed significantly to this measure.

Action plans in idiopathic pulmonary fibrosis: a qualitative study—‘I do what I can do’

BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive, incurable fibrotic lung disease in which patients and caregivers report a high symptom burden. Symptoms are often poorly managed and patients and caregivers...

Effect of Psychoeducation Intervention on Self-efficacy and Coping of Adolescent Thalassemic Survivors in Indonesia

Thalassemia is a chronic illness with having serious psychological challenges for adolescent thalassemic survivors. Many experienced problematic issues with their self-efficacy and coping as impacts of the disease and its treatments. Although thalassemia is a major health problem in Indonesia that challenges health care professionals to improve adolescent thalassemic survivors&amp;#39; quality of life, no studies have been undertaken to improve self-efficacy and coping of those adolescents with thalassemia by using psycho-education. This research aim was to examine the effect of psycho-education on self-efficacy and coping of adolescents with thalassemia. The study was conducted in two hospitals in Garut, Indonesia. The research method used was quasi-experiment with the pre-post test without the control group. The participants were thalassemic adolescent survivors aged 12-18 years old with 48 determined by total sampling technique. All participants received the psycho-education intervention with lecturing and booklet. Participants&amp;#39; self-efficacy was measured with the Chronic Disease Self-Efficacy Scales (CDSES), and their coping was measured with the Ways of Coping (WOC) Scale. The collected data were analized by using the Shapiro-Wilks to test for normality and the Wilcoxon test. The results showed there was meaningful difference with self-efficacy before and after intervention (p&amp;lt;0,001), and meaningful difference on adolescent thalassemic survivors&amp;rsquo;coping before and after intervention (p=0,004). It can be concluded that there was a significant effect of psycho-education on self-efficacy and coping of those adolescent thalassemic survivors. Therefore, it is recommended that the psycho-education intervention can be used as one of nursing intervention for enhancing self-efficacy and coping of adolescents with major thalassemia.

Illness Representation and Self-Efficacy: An Exploration of Fatigue Factors in Middle-Aged Stroke Survivors.

The purpose of this study is twofold: to examine the relationship between illness representation and self-efficacy and to test the determinants and the effect of self-efficacy, resilience, and stroke impact on fatigue in middle-aged stroke survivors. This study used a cross-sectional and quantitative approach. The instruments included the Chronic Disease Self-Efficacy Scale, Stroke Impact Scale, Resilience Scale, and Fatigue Impact Scale. Structural equation modeling (SEM) was performed to analyze the data. A total of 63 patients with stroke (39 male and 24 female) were recruited form a medical university hospital. The results showed that patients' illness representation had a significantly effect on self-efficacy for managing disease. In addition, SEM analysis demonstrated that self-efficacy, resilience and stroke impact influenced fatigue, explaining 20.6% of the variance in fatigue. It was concluded that to improve patient fatigue, we believe it is imperative to design interventions that improve patients' self-efficacy, promote patients' resilience, and better function.

Self-Efficacy Among Indonesian Chronic Liver Disease Patients

Chronic Liver Diseases are among the most extensive diseases globally and are related to significant morbidity and mortality. Although physical well-being has long been the primary goal of medical care, as chronic disease becomes more prevalent in developed countries, there has been a greater focus on patients' emotional and social well-being. This study aimed to describe the self-efficacy among chronic liver disease patients in North Sumatra, Indonesia. This study uses a cross-sectional design. The study assessed 102 chronic liver disease patients from two hospitals using the Chronic Disease Self-Efficacy Scales Indonesian version. The participants had moderate self-efficacy (58.8%), followed by high self-efficacy (38.2%). The majority of the patients in this study had moderate self-efficacy because many individuals with chronic liver disease suffer chronic fatigue, abdominal pain and swelling, itchy skin, nausea or vomiting, loss of appetite, and other symptoms that affect self-efficacy. Health professionals should strengthen patients' self-efficacy by engaging in positive activities and enhancing their coping skills

A structural equation model of health-related quality of life among Thai men with chronic obstructive pulmonary disease.

To identify physiological, psychological and socioenvironmental factors that affect the health-related quality of life of Thai men living with chronic obstructive pulmonary disease. The vast majority of Thai persons living with chronic obstructive pulmonary disease are men. Little is known about the health-related quality of life of Thai people living with chronic obstructive pulmonary disease or about the physiological and psychosocial factors that most affect it. Applying a prevailing theoretical model of health-related quality of life, we explored how physiological, psychological and socioenvironmental factors simultaneously affect the health-related quality of life of Thai men with chronic obstructive pulmonary disease. A cross-sectional study design was used, together with the STROBE checklist. In this study, 290 Thai male outpatients at a chronic obstructive pulmonary disease specialist clinic near Bangkok were recruited using purposive sampling. The participants completed the Satisfaction With Life Scale, the St. George Respiratory Questionnaire, the Center for Epidemiologic Studies Depression Scale, the Short Form Health Survey Version 2, the chronic obstructive pulmonary disease Self-Efficacy Scale and the Social Support Questionnaire. A structural equation model was used to examine the relationships between the assessed variables. Biological function (FEV-1, chronic obstructive pulmonary disease exacerbations), symptoms (chronic obstructive pulmonary disease and depression), functional status, general health perceptions and individual characteristics (age and self-efficacy to control dyspnoea) accounted for 56.9% of the variance in health-related quality of life. Symptoms of chronic obstructive pulmonary disease and depression were the main factors with statistically significant direct and indirect effects on the health-related quality of life of the Thai men in this study. The effects of both symptoms included an indirect effect on health-related quality of life through functional status and general health perceptions. The study findings may help nurses to better understand factors affecting health-related quality of life among men with chronic obstructive pulmonary disease. Preventing or minimising symptom exacerbations could be important in nursing practice. Cognitive-behavioural interventions addressing chronic obstructive pulmonary disease symptom management, depression screening and smoking cessation may improve health-related quality of life among Thai men with chronic obstructive pulmonary disease.

Exploring psychosocial factors associated with frailty incidence among patients undergoing maintenance hemodialysis.

We investigated the correlation between the frailty status of maintenance haemodialysis (MHD) patients and psychosocial factors. Varying degrees of frailty have been reported in MHD patients, which affect their quality of life. We adopted a cross-sectional design in this study. Clinical data of 187 patients at our centre were collected from December 2017-June 2018 using a cross-sectional survey. Psychosocial factors were measured using the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, 10-item Connor-Davidson Resilience Scale (CD-RISC), Chronic Disease Self-Efficacy Scales and Perceived Social Support Scale. Frailty status was estimated using the fatigue, resistance, ambulation, illnesses and loss of weight (FRAIL) scale. Spearman's correlation and multiple logistic regression analysis were conducted to identify the risk factors for frailty. This study complied with the STROBE checklist. Of 187 patients, 11 cases (5.9%) of frailty were identified. Patient's age, comorbidities, parathyroid hormone level, sleep quality and depression were positively correlated with frailty (p<.05), while psychological resilience and social support were negatively correlated with frailty (p<.05). Logistic regression analysis revealed four risk factors for frailty among MHD patients, including age (p=.004), comorbidities (p=.023), depression (p=.023) and sleep disorders (p=.029). Conversely, protective factors included high psychological resilience (p=.019) and social support (p=.039). Among MHD patients, the risk factors for frailty included age, comorbidity, depression and sleep disturbance, whereas the protective factors included psychological resilience and social support. Frailty is not only common among older patients, but also among people of all age groups suffering from chronic diseases. Therefore, it is important to consider the health status of MHD patients and adopt targeted nursing strategies to alleviate symptoms of frailty and improve physical condition by the following ways: postpone the progress of comorbidities, improve sleep quality, control the symptoms of depression, foster psychological resilience and facilitate support from social and family.

Self-management behavior based on structural equation model in elderly chronic heart failure patients

Objective To investigate the self-management of elderly chronic heart failure (CHF) patients and to explore the structural equation modeling (SEM) on the influencing factors of self-management behavior among CHF patients so as to provide a basis for constructing the self-management education plan for elderly CHF patients suitable for the characteristics of our country. Methods From January 2015 to June 2017, The study selected 6 124 elderly patients in 102 hospitals of 16 provinces, cities and autonomous region from 5 areas, east China, west China, south China, north China and central China by random cluster sampling as subjects. All of patients were investigated with the self-management scale of heart failure patients, heart failure knowledge questionnaire, chronic disease self-efficacy scale, self-concept scale and the medica coping modes questionnaire. AMOS 22.0 was used to construct the model on the influencing factors of self-management behavior among CHF patients. Results The total score self-management of 6 124 elderly CHF patients was [49.00 (43.00, 54.00) ] with 61.25% for the scoring rate. The SEM on the direct or indirect influencing factors of self-management among elderly CHF patients fitted well. The influencing factors of self-management included the per-capita incomes, works, self-care, nations, religious belief, education levels, heart failure knowledge, self-concept, self-efficacy, coping styles. Conclusions Self-management of elderly CHF patients are in the below average level influenced by different demographers, cultural background and heart failure knowledge. Medical staff should formulate a systematic and individual self-management education plan for elderly CHF patients based on patients' demographic characteristics, cultural background, heart failure knowledge, self-concept and self-efficacy to improve their self-management. Key words: Aged; Chronic heart failure; Self-management; Structural equation model