Perceived self-efficacy and self-managing of chronic diseases among elderly patients in a clinic setting: how capable are elders in promoting their own health?

Abstract

Introduction: Non-communicable diseases and elderly population are on the rise worldwide. It has created a massive burden on health systems, economies and society. Sri Lanka is no exception. The situation indicates the need for risk factor prevention and control through effective behaviour change programmes. Self-efficacy is postulated as fundamental to achieve behaviour change of individuals to fill the present gap of risk factor control. Objectives: To assess the perceived self-efficacy in managing chronic diseases to provide an insight into how confident the elderly are in self-managing their diseases Methods: A hospital-based descriptive cross-sectional study was conducted among elderly patients attending the medical clinic at BH Mulleriyawa. By systematic sampling method, 461 eligible patients diagnosed with one or more five major chronic disease categories were selected. An interviewer-administered chronic disease selfefficacy questionnaire validated for Western countries was used to collect data. Mean perceived self-efficacy score was calculated by adding scores of 10 domains. Adjusted odds ratios (AOR) with 95% confidence interval (CI) were calculated to find associations with the control of risk factors. Results: The response rate was 92% (n=424). The study population had a mean perceived self-efficacy score of 3.64 (SD=0.54) out of 5. The existence of multiple co-morbidities among the elderly was significantly associated with perceived self-efficacy (p=0.02). Respondents with a single disease showed ‘good’ perceived self-efficacy compared to those with two or more co-morbidities. With respect to disease control status, a statistically significant association was found between ‘good’ perceived self-efficacy and blood pressure control (<140/90 mmHg) (AOR=0.47; 95% CI=0.24, 0.89). However, statistically significant associations were not found between blood sugar control (<110 mg/dl) or total cholesterol level (<240 mg/dl) with ‘good’ perceived self-efficacy. Conclusions: The elderly patients’overall perceived self-efficacy level was found to be well above the average. Targeted interventions to improve self-efficacy may have a beneficial effect on disease control factors such as blood pressure. Further research studies are needed to longitudinally assess the temporality of perceived selfefficacy and its determinants.

Keywords

• perceived self-efficacy, chronic diseases, elderly