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Kalantzi V, Tsiampalis T, Kouvari M, Belitsi V, Zairis A, Migdanis A, Papadopoulou SK, Bonoti F, Panagiotakos DB, Kosti RI. Exploring the Role of Self-Efficacy in Maintaining Healthy Lifestyle Habits among Patients with Cardiometabolic Diseases; Findings from the Multi-Center IACT Cross-Sectional Study. Life (Basel) 2024; 14:736. [PMID: 38929719 PMCID: PMC11204498 DOI: 10.3390/life14060736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/01/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: Cardiometabolic disease progression can be delayed if patients engage in healthy lifestyle behaviors, adherence to which is highly influenced by psychosocial factors. The present study aimed at investigating the association of self-efficacy with the adherence level to healthy lifestyle behaviors among patients with cardiometabolic diseases in Greece. (2) Methods: 1988 patients (1180 females) with cardiometabolic diseases participated. Anthropometric, demographic, socioeconomic, clinical, and lifestyle characteristics were recorded. Patients were also asked to evaluate their efficacy to comply with healthy lifestyle behaviors. (3) Results: The majority exhibited unhealthy lifestyle behaviors. A subgroup demonstrated elevated self-efficacy in maintaining healthy habits despite facing diverse psychosocial challenges. Individuals with higher educational attainment, socioeconomic status, and rural/semi-urban residency had significantly elevated self-efficacy. Those with heightened self-efficacy exhibited significantly lower BMI and reduced prevalence of certain health conditions. Self-efficacy significantly influenced adherence to the Mediterranean diet, physical activity engagement, and smoking cessation, even in challenging circumstances. (4) Conclusions: This study represented an innovative approach in examining the role of self-efficacy in shaping health behaviors and outcomes within a Greek population. By integrating specific psychosocial circumstances into the analysis, valuable insights were provided into the contextual factors influencing self-efficacy and adherence to healthy lifestyle behaviors.
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Affiliation(s)
- Vasiliki Kalantzi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece; (V.K.); (T.T.); (M.K.); (V.B.); (A.M.); (F.B.)
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece; (V.K.); (T.T.); (M.K.); (V.B.); (A.M.); (F.B.)
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece;
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece; (V.K.); (T.T.); (M.K.); (V.B.); (A.M.); (F.B.)
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece;
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Vasiliki Belitsi
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece; (V.K.); (T.T.); (M.K.); (V.B.); (A.M.); (F.B.)
| | - Antonios Zairis
- Department of Economics and Business, School of Economics, Business and Computer Sciences, Neapolis University, Paphos 8042, Cyprus;
| | - Athanasios Migdanis
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece; (V.K.); (T.T.); (M.K.); (V.B.); (A.M.); (F.B.)
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Fotini Bonoti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece; (V.K.); (T.T.); (M.K.); (V.B.); (A.M.); (F.B.)
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17676 Athens, Greece;
- Faculty of Health, University of Canberra, Canberra, ACT 2617, Australia
| | - Rena I. Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221 Trikala, Greece; (V.K.); (T.T.); (M.K.); (V.B.); (A.M.); (F.B.)
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Korenhof SA, Rouwet EV, Elstgeest LEM, Fierloos IN, Tan SS, Pisano-Gonzalez MM, Boone ALD, Pers YM, Pilotto A, López-Ventoso M, Diez Valcarce I, Zhang X, Raat H. The effect of a community-based group intervention on chronic disease self-management in a vulnerable population. Front Public Health 2023; 11:1221675. [PMID: 37670825 PMCID: PMC10475542 DOI: 10.3389/fpubh.2023.1221675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/24/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction Chronic non-communicable diseases (NCDs) are predominantly related to modifiable health behaviors and account for 74% of global deaths at present. Behavior modification through self-management is a strategy to prevent NCDs. Chronic Disease Self-Management Programs (CDSMPs) have demonstrated improvements in health behaviors, health status, and use of healthcare. Objective We evaluated the effects of a 6-week CDSMP on self-efficacy, health behaviors, mental health, health-related quality of life (HR-QoL), and health responsibilities among vulnerable populations with chronic disease in Europe. Methods A prospective cohort study with a 6-month pre-post single-group design was conducted in five European countries. The intervention targeted adults with chronic conditions and low socioeconomic status, as well as their caregivers. The intervention was a 6-week community-based CDSMP in a group setting. Outcomes were measured per self-report questionnaire at baseline and 6-month follow-up: self-efficacy, health behaviors, mental health, HR-QoL, and health responsibilities. Results Of 1,844 participants, 1,248 (67.7%) completed follow-up and attended ≥4 sessions. For the chronic condition group, the following outcome measures at follow-up significantly improved compared with baseline (all P < 0.002): self-efficacy (SEMCD-6 6.7 vs. 6.4), mental health (PHQ-8 6.3 vs. 7.0), HR-QoL (SF-12 PCS 42.3 vs. 40.2, SF-12 MCS 42.8 vs. 41.4), health utility (EQ-5D-5L 0.88 vs. 0.86), self-rated health (EQ-5D-5L 67.2 vs. 63.9), communication with healthcare providers (2.28 vs. 2.11), understanding information (3.10 vs. 3.02), number of doctor visits (3.61 vs. 4.97), accident and emergency department visits (0.25 vs. 0.48), total nights in a hospital (0.65 vs. 1.13), and perceived medical errors (19.6 vs. 28.7%). No significant changes were detected in dietary habits, physical activity, substance use, and sleep and fatigue. For caregivers without a chronic condition, only doctor visits significantly decreased (1.54 vs. 2.25, P < 0.001). Discussion This CDSMP was associated with improvement in self-efficacy, depression, HR-QoL, and health responsibilities over 6 months in a diverse European population with a chronic condition. However, additional interventions targeting lifestyle risk factors are needed to improve health outcomes.
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Affiliation(s)
- Sophie A. Korenhof
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ellen V. Rouwet
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Liset E. M. Elstgeest
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, Netherlands
| | - Irene N. Fierloos
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Siok Swan Tan
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Research Group City Dynamics, InHolland University of Applied Sciences, Rotterdam, Netherlands
| | - Marta M. Pisano-Gonzalez
- Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), General Directorate of Care, Ministry of Health, Oviedo, Spain
| | - An L. D. Boone
- Public Health General Directorate, Ministry of Health of the Principality of Asturias, Oviedo, Spain
| | - Yves-Marie Pers
- IRMB, University of Montpellier, INSERM, CHU Montpellier, Montpellier, France
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Department of Rheumatology, Lapeyronie University Hospital, Montpellier, France
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Mónica López-Ventoso
- Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), General Directorate of Care, Ministry of Health, Oviedo, Spain
| | - Isabel Diez Valcarce
- Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), General Directorate of Care, Ministry of Health, Oviedo, Spain
| | - Xuxi Zhang
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | | | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
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Wu Y, Wen J, Wang X, Wang Q, Wang W, Wang X, Xie J, Cong L. Chinese Community Home-Based Aging Institution Elders' Self-Management of Chronic Non-Communicable Diseases and Its Interrelationships with Social Support, E-Health Literacy, and Self Efficacy: A Serial Multiple Mediation Model. Patient Prefer Adherence 2023; 17:1311-1321. [PMID: 37255948 PMCID: PMC10226538 DOI: 10.2147/ppa.s412125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/15/2023] [Indexed: 06/01/2023] Open
Abstract
Background The Chinese population is aging, and chronic non-communicable diseases (NCDs) prevalence is correspondingly increasing, along with associated disability and healthcare costs. Although self-management has been associated with social support and is a recognized priority, its mediating variables have not been studied in detail, particularly among old people with chronic diseases. Purpose To examine the mediating role of e-health literacy and general self-efficacy in the relationship between social support and self-management of chronic NCDs in Chinese community home-based aging institution residents. Patients and Methods A random sample of 289 community home-based aging institution elders (≥60 years) with chronic NCDs in China was recruited. Questionnaire data were recorded on self-reported socio-demographics, self-management, social support, e-health literacy, and general self-efficacy. Pearson's correlation analysis identified the relationship between these factors and self-management. Serial multiple mediation model was used to test the hypothesized relationships. Results The self-management mean (±SD) score was 29.39 ± 9.60, and the level of self-management was medium. Social support (r = 0.283; P < 0.001), e-health literacy (r = 0.566; P < 0.001), and general self-efficacy (r = 0.477; P < 0.001) were positively associated with self-management. Furthermore, social support indirectly influenced self-management through three pathways: independent mediation of e-health literacy (effect = 0.234, P < 0.001), independent mediation of general self-efficacy (effect = 0.515, P < 0.001), and chain mediation of e-health literacy and general self-efficacy (effect = 0.075, P < 0.001). Conclusion In Chinese community home-based aging institution elders, the relationship between self-reported self-management and social support is positively affected by the independent mediating effect of e-health literacy and general self-efficacy and the serial mediating effect of e-health literacy and general self-efficacy. Targeted self-management programs for elders with chronic NCDs have theoretical support, which could improve the health status and quality of life in this population.
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Affiliation(s)
- Ying Wu
- School of Medicine, Hunan Normal University, Changsha, 410013, People’s Republic of China
| | - Jing Wen
- School of Medicine, Hunan Normal University, Changsha, 410013, People’s Republic of China
| | - Xiaohui Wang
- School of Medicine, Hunan Normal University, Changsha, 410013, People’s Republic of China
| | - Qingyao Wang
- School of Medicine, Hunan Normal University, Changsha, 410013, People’s Republic of China
| | - Wen Wang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, 41008, People’s Republic of China
| | - Xiangjia Wang
- School of Medicine, Hunan Normal University, Changsha, 410013, People’s Republic of China
| | - Jiang Xie
- School of Medicine, Hunan Normal University, Changsha, 410013, People’s Republic of China
| | - Li Cong
- School of Medicine, Hunan Normal University, Changsha, 410013, People’s Republic of China
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