Trajectories of self-efficacy in persons with chronic illness: An explorative longitudinal study

Background: Self-efficacy is important for changing health behaviour in persons with chronic illness. Longer term trajectories have not been previously explored.

Objective: This study’s objective was to explore the trajectories of self-efficacy in two different groups with chronic illnesses attending a patient education course.

Design: The study design was a longitudinal, comparative cohort study with five time points during a one-year follow-up, using repeated measures analysis of variance.

Setting and participants: Persons with morbid obesity (n = 55) and persons with chronic obstructive pulmonary disease (COPD; n = 56) were recruited at the start of patient education courses in Norway and followed-up four times the following year.

Main outcome measure: The General Self-Efficacy Scale was the main outcome.

Results: Obese persons showed a linear pattern of increasing self-efficacy during the follow-up period, whereas persons with COPD had an initial increase followed by a decrease in self-efficacy. Having paid work was associated with a more positive self-efficacy trajectory.

Conclusion: The results provide support for the currently employed patient education course for morbidly obese persons. In contrast, persons with COPD may need more extensive and/or more frequent support in order to increase and maintain self-efficacy across time.     

The Roles of Social Support and Self-Efficacy in Physical Health’s Impact on Depressive and Anxiety Symptoms in Older Adults

Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.     

Gender differences in social cognitive determinants of exercise adoption

Gender differences in lifestyle-related mortality and morbidity suggest a need to investigate gender-specificity of health behaviour change process and factors influencing it. We tested whether changes in self-efficacy beliefs and planning, as well as the level of social support predict change in exercise. Finnish men and women, aged 50–65 years, at an increased risk for type 2 diabetes were recruited from health care centres to participate in the Good Ageing in Lahti Region (GOAL) Lifestyle Implementation Trial. Psychosocial factors were measured with questionnaires and exercise with 7-day physical activity diaries at baseline and at 3 months. At baseline, no gender differences were found in self-efficacy and planning, but men reported receiving more social support than women. At 3 months, women reported having formed more action plans for changing their exercise routines than men. Among women, increase in self-efficacy and planning predicted increase in exercise. Among men, changes in planning played a less significant role. The more salient role of planning for women than for men, and the fact that women receive less social support, may reflect life circumstances allowing less spontaneous lifestyle decisions and a lower acceptance of lifestyle changes by their social environment.     

Social Support Provision to HIV-Infected Gay Men1

The study examined associations between attitudes toward homosexuality, fear of AIDS, blame of persons infected with the HIV-virus, and social support provision to these individuals. A sample of HIV-infected gay men reported on the support they receive from specific members of their social networks. These network members then completed questionnaires assessing the predictor variables. Homophobia, homosexual preference, and the interaction of these two variables were positively associated with blame. Blame, together with fear of AIDS and low levels of psychological well-being, were negatively associated with provision of emotional support. Fear of AIDS was also related to negative changes in the quality of recipients' and providers' relationships. Finally, emotional support was strongly related to adjustment to illness among support recipients. Results suggest important points for intervention to promote adjustment to HIV infection among gay men.     

Psychological mechanisms underlying the relationship between commercial physical activity app use and physical activity engagement

PurposePrevious studies have indicated a relationship between the use of commercial physical activity apps (e.g., Fitbit, Strava) and physical activity engagement. The use of social components of such apps, in particular app-specific communities (connecting with other app users) and existing social networking platforms (e.g., Facebook) have the potential to enhance physical activity. This study aimed to explore the psychological mechanisms underlying the relationship between the use of commercial physical activity apps (and their social components) and physical activity engagement.MethodAn online cross-sectional survey assessed physical activity, use of commercial physical activity apps (and their associated social components), and psychological constructs (social support, self-efficacy, motivation, trait competitiveness, trait social comparison).Results1274 adults aged 18–83 years (M_age = 34.1 ± 13.5 years, 87.6% female) participated. App use was positively associated with physical activity engagement. The relationship between app use and physical activity was fully mediated by social support, self-efficacy, intrinsic motivation and identified regulation. Trait competitiveness, but not trait social comparison, moderated the relationship between app use and physical activity. Most features (e.g., sharing posts, providing or receiving encouragement) of the social components of apps were positively associated with psychological constructs linked to engagement in physical activity. Mediation pathways linking features of existing social networking platforms with physical activity were found. Specifically, sharing posts was linked to higher engagement in physical activity via positive associations with self-efficacy, and receiving encouragement with linked to higher engagement in physical activity via positive associations with both self-efficacy and identified regulation. In addition, engagement in comparisons was associated with lower self-efficacy and higher external regulation, and in turn, lower physical activity.ConclusionsThe relationship between the use of commercial physical activity apps and physical activity is underpinned by social support, self-efficacy and autonomous motivations. The findings highlight the importance of trait competitiveness, which should be taken into consideration when leveraging physical activity apps. Overall, the present study demonstrated that commercial physical activity apps (and their social components) hold great potential to increase physical activity engagement given their associations with psychological constructs strongly linked with physical activity.     

Emotional Reactions to Health Status Changes and Emotional Well-Being Among HIV-Positive Persons with Limited Reading Literacy

People living with HIV-AIDS experience emotional distress in response to negative changes in their health status. The current study hypothesized that individuals with poorer health literacy skills would evidence greater emotional distress in response to negative changes in health status compared to persons with higher health literacy skills. HIV positive persons (N = 294) completed anonymous surveys that included measures of depression and social support and a subset of 98 participants completed two experimental vignettes depicting a person receiving test results showing an increase in HIV viral load (negative health changes) followed by a vignette suggesting decreased viral load (improved health changes). Responses to affective reactions and coping strategies indicated that persons with lower health literacy skills more strongly endorsed negative affective states and maladaptive coping strategies compared to persons with higher health literacy skills. In addition, lower health literacy was associated with greater symptoms of affective depression and poorer social support, whereas higher literacy was associated with greater negativistic thinking. Findings suggest the need for patient education and counseling regarding changes in health status among people living with HIV-AIDS, particularly persons with limited health literacy skills.     

The relationship of perceived self-efficacy to quality of life in chronic obstructive pulmonary disease.

From a biomedical perspective, variations in the quality of life of chronic obstructive pulmonary disease (COPD) patients may be attributed to changes in pulmonary function; thus, an increase in lung function should be correlated with an increased score on a health-related quality-of-life measure. However, inconsistent results regarding correlations between various measures of pulmonary function and quality of life have been reported in the literature. The authors evaluated a social cognitive model of quality of life among persons with COPD by analyzing relationships among biomedical measures, self-efficacy measures, and quality-of-life measures in a recursive path model. Path analysis results indicated that the association of pulmonary function and symptoms with quality of life was mediated by perceived self-efficacy for functional activities.     

Mosque-Based Emotional Support Among Young Muslim Americans

Despite a growing literature on social support networks in religious settings (i.e., church-based social support), little is known about mosque-based support among Muslims. This study investigates the demographic and religious behavior correlates of mosque-based social support among a multi-racial and ethnic sample of 231 young Muslims from southeast Michigan. Several dimensions of mosque-based support are examined including receiving emotional support, giving emotional support, anticipated emotional support and negative interactions with members of one’s mosque. Results indicated that women both received and anticipated receiving greater support than did men. Higher educational attainment was associated with receiving and giving less support compared to those with the lowest level of educational attainment. Moreover, highly educated members reported fewer negative interactions than less educated members. Mosque attendance and level of congregational involvement positively predicted receiving, giving, and anticipated emotional support from congregants, but was unrelated to negative interactions. Overall, the study results converge with previously established correlates of church-based emotional support.     

Depressive Symptomatology among HIV-Positive Women in the Era of HAART: A Stress and Coping Model

Objective: An enhanced stress and coping model was used to explain depression among HIV-positive women in healthcare and community settings where highly active anti-retroviral treatment (HAART) was commonplace. Method: HIV-infected women in four cities (N=978) were assessed, cross-sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self-reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self-efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self-efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self-efficacy, bolstering social supports, and decreasing stress in the lives of HIV-positive women may help to reduce the negative effects of HIV disease on mood.     

Developing a model for online support group use,empowering processes and psychosocial outcomes for individuals living with HIV/AIDS

This study examined the mechanism through which online support group (OSG) participation may promote patient empowerment among 340 individuals living with HIV/AIDS. Results from structural equation modelling revealed that greater use of OSGs was associated with more frequent occurrence of the empowering processes as measured by receiving useful information, receiving social support, finding positive meaning and helping others. Receiving useful information and finding positive meaning were related to higher levels of adaptive coping and lower levels of maladaptive coping, while receiving social support and helping others were related to higher levels of self-care self-efficacy, which in turn was related to higher levels of adaptive coping, and lower levels of maladaptive coping. Finally, higher levels of maladaptive coping were related to poorer quality of life, while higher levels of adaptive coping were related to better quality of life. Results suggest that OSG participation may offer some benefits for those living with HIV/AIDS.     

Relations of perceived physical self-efficacy and motivational responses toward physical activity by urban high school students

To be effective in promoting physical activity among urban, minority adolescents, the factors and psychological processes that motivate them to engage in and maintain a physically active lifestyle should be examined. The relation of physical self-efficacy and motivational responses toward physical activity in 46 urban minority adolescents was explored. As hypothesized, there were significant positive relationships among Percieved Physical Ability, Physical Self-presentation Confidence, Effort, and Enjoyment (coefficients ranged from .29 to .80), suggesting that participants who had higher perceived physical ability were likely to report higher perceptions of self-presentation, more enjoyment of physical activity, and harder work in physical activity. These results indicate specific relationships among Effort, Enjoyment, Perceived Physical Ability, and Physical Self-presentation Confidence in this sample. Physical self-efficacy appears to be a stronger predictor of motivational responses in physical activity. Practical implications for physical educators include incorporating strategies known to develop self-efficacy, such as mastery experiences involving successive trials of increasing difficulty, self-observation, external feedback, peer modeling, and verbal persuasion.     

Developing a model for online support group use, empowering processes and psychosocial outcomes for individuals living with HIV/AIDS

This study examined the mechanism through which online support group (OSG) participation may promote patient empowerment among 340 individuals living with HIV/AIDS. Results from structural equation modelling revealed that greater use of OSGs was associated with more frequent occurrence of the empowering processes as measured by receiving useful information, receiving social support, finding positive meaning and helping others. Receiving useful information and finding positive meaning were related to higher levels of adaptive coping and lower levels of maladaptive coping, while receiving social support and helping others were related to higher levels of self-care self-efficacy, which in turn was related to higher levels of adaptive coping, and lower levels of maladaptive coping. Finally, higher levels of maladaptive coping were related to poorer quality of life, while higher levels of adaptive coping were related to better quality of life. Results suggest that OSG participation may offer some benefits for those living with HIV/AIDS.     

The chronic illness quality of life (CIQOL) model: explaining life satisfaction in people living with HIV disease.

The chronic illness quality of life (CIQOL) model theorizes that life satisfaction in persons living with a chronic illness such as HIV disease is a function of illness-related discrimination, barriers to health care and social services, physical well-being, social support, and coping. The CIQOL model was evaluated using data from 275 persons living with HIV disease. Women reported less life satisfaction and confronted more barriers to health care and social services than men, and White participants reported higher perceptions of AIDS-related discrimination than non-White participants. The CIQOL model provided an excellent fit to study data (root-mean-square error of approximation = .03) and accounted for almost a third of the variance in life satisfaction scores. Barriers to health care and social services played a particularly prominent role in the model.     

Emotional support from parents early in life, aging, and health

The purpose of this study is to estimate the relationship between receiving emotional support from parents early in life and an individual's health in adulthood. Analysis of data from a nationally representative sample of adults ages 25-74 years suggests that a lack of parental support during childhood is associated with increased levels of depressive symptoms and chronic conditions in adulthood. These associations between early parental support and adult health persist with increasing age throughout adulthood. Personal control, self-esteem, and social relationships during adulthood account for a large portion of these long-term associations. These findings underscore the importance of adopting a life course perspective in studying the social determinants of health among adults.     

Use of Social Support: Gender and Personality Differences

Sex differences in social support have been explained in terms of gender differences in socialization and personality. The current research focused directly on the link between social support and gender variables. An adult, largely Caucasian sample of both sexes reported an experience in which they had received support, and were assessed on masculinity, femininity, nurturance, affiliation, autonomy, and self-confidence. The results revealed that gender, but not sex, was significantly correlated with patterns of social support. Femininity (in both sexes) was associated with seeking and receiving emotional support, and with seeking and receiving support from women. Masculinity (in both sexes) was linked only with receiving tangible support. These findings argue for the significance of femininity in promoting a more social form of well-being, and underscore the importance of studying gender directly rather than relying on sex as a proxy variable.     

Physical activity, social support, and depression: possible independent and indirect associations in persons with multiple sclerosis

The present study examined the pattern of associations among physical activity, social support, mobility disability, perceived stress, and depressive symptoms in relapsing-remitting MS (RRMS). Persons (N?=?218) with RRMS completed a battery of questionnaires that was sent and returned through the United States Postal Service (USPS). Bivariate correlation analysis indicated that physical activity and social support were both inversely associated with depressive symptoms (r's?=?-0.288 and -0.386, p ≤ 0.05, respectively). Multiple linear regression analysis indicated that physical activity (β?=?-0.21, p?=?0.002) and social support (β?=?-0.37, p?=?0.0001) were independently associated with depressive symptoms. Path analysis confirmed that the associations between physical activity and social support with depressive symptoms were indirect via mobility disability and perceived stress. Collectively, the evidence indicates that physical activity and social support are independently and indirectly associated with depression via mobility disability and perceived stress in relapsing-remitting MS. This supports the design of interventions and programs that target physical activity and social support for reducing depressive symptoms among persons with MS.     

The influence of seriousness and contagiousness of disease on emotional reactions to ill persons

Abstract

Extends research on illness cognition by arguing that two major dimensions of illness cognition - seriousness and contagiousness of disease - are responsible for different emotional responses to ill persons, and that the activation of these dimensions is dependent on type of contact with these persons. Using a vignet methodology, nursing students (N = 333) were asked to imagine having different types of contact with patients with diseases differing in seriousness and contagiousness. When participants imagined personal contact with the patient, their anxiety responses and self-efficacy expectations were primarily determined by seriousness of disease. In contrast, when they anticipated close physical contact with the patient, subjects' anxiety reactions and self-efficacy expectations were primarily influenced by contagiousness of disease. Seriousness of disease appeared to be a major determinant of feelings of pity, poweriessness, sadness, and motivation to psychologically support the patient. Theoretical and practical implications are discussed.     

Predicting posttraumatic growth among Hurricane Katrina survivors living with HIV: the role of self-efficacy,social support,and PTSD symptoms

Abstract

The study tested the model of adaptation after trauma by Benight and Bandura (2004) indicating that posttraumatic recovery may be predicted directly by coping self-efficacy (CSE) and indirectly by social support. These relations were investigated in the context of posttraumatic growth (PTG) among Hurricane Katrina survivors living with HIV. Additionally, it was hypothesized that among individuals with more intensive Posttraumatic Stress Disorder (PTSD) symptoms, those with strong CSE would experience the strongest PTG. Cross-sectional data were collected among 90 patients with HIV who reinitiated care at the HIV outpatient clinic. Questionnaires were administered approximately 14 months after the hurricane. Higher CSE was related to higher PTG among the survivors who suffered from more intensive PTSD symptoms. Received social support was directly related to only one index of PTG, relating to others. Furthermore, although there was a significant relationship between social support and CSE, the indirect conditional effect of received social support on PTG was not confirmed. Similar results were obtained across the indices of PTG, controlling for the level of exposure to hurricane-related trauma. Cross-sectional design and convenience character of the sample warrants replications.     

Predicting outcome of chronic pain treatment via a modified self-efficacy scale

This study utilized a modified self-efficacy scale and examined the relationship of perceived self-efficacy to treatment outcome in a chronic, intractable, benign pain population (N = 62). In two separate studies a self-efficacy scale was given to inpatients in a combined cognitive-behavioral and medical treatment program. The scale categories consisted of (1) walking distance, (2) lifting ability, (3) pain coping, (4) working ability, and (5) social and recreational engagement. Self-efficacy beliefs were found to be associated with the level of functioning of these patients and their response to treatment. Patients with higher self-efficacy scores following treatment rated themselves as more improved and demonstrated better overall functioning with greater reductions in chronic illness behavior at followup. These observations support the merits of self-efficacy measures as predictors of treatment outcome in chronic pain patients.     

Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial

The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n?=?47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d?=?0.68) than the control condition (d?=?0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r?=?0.62) and barriers self-efficacy (r?=?0.63) and decreases in depression (r?=?-0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling.