The association of education level with autonomy support, self-efficacy and health behaviour in patients with cardiovascular risk factors.
chronic disease
health behaviour
health personnel
nurse-patient relations
personal autonomy
self-efficacy
Journal
Journal of clinical nursing
ISSN: 1365-2702
Titre abrégé: J Clin Nurs
Pays: England
ID NLM: 9207302
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
revised:
30
07
2021
received:
26
04
2021
accepted:
12
08
2021
pubmed:
29
8
2021
medline:
20
5
2022
entrez:
28
8
2021
Statut:
ppublish
Résumé
The study aimed to investigate whether the patients' education level affected the mediation effect of self-efficacy on the relationship between the autonomy-supportive healthcare climate and health behaviour among patients with cardiovascular risk factors. Autonomy and self-efficacy are identified as influential factors related to the behaviours of individuals with health problems. However, it is unclear whether autonomy support from healthcare providers affects health behaviour through self-efficacy and if patients' education level affects the association. A cross-sectional study. A convenience sample of 207 individuals with one or more cardiovascular diseases completed self-administered surveys including the healthcare climate questionnaire, self-efficacy scale and the engagement in health behaviour scale. Data were analysed using descriptive statistics, t test, Pearson's correlation coefficients and hierarchical regression analysis. All procedures of the study adhered to the STROBE guidelines. The influence of autonomy support from healthcare providers on self-efficacy differed by individuals' education level. Self-efficacy in less educated, but not highly educated individuals, tended to depend on the autonomy-supportive climate. Additionally, the autonomy-supportive healthcare climate affected health behaviour through self-efficacy only in less educated individuals. The relationship between autonomy support from healthcare providers and self-efficacy was more evident in the relatively less educated individuals. The associations among autonomy support, self-efficacy and health behaviour differed by patient education level, and the mediating role of self-efficacy on the relationship between autonomy-supportive climate and health behaviour was found only in those less educated. Healthcare providers should recognise the importance of supporting patients' need for autonomy to improve self-efficacy and healthy behaviour, particularly in less educated patients. Additionally, healthcare providers' support tailored to patients' needs and educational status should be highlighted.
Sections du résumé
AIM AND OBJECTIVES
OBJECTIVE
The study aimed to investigate whether the patients' education level affected the mediation effect of self-efficacy on the relationship between the autonomy-supportive healthcare climate and health behaviour among patients with cardiovascular risk factors.
BACKGROUND
BACKGROUND
Autonomy and self-efficacy are identified as influential factors related to the behaviours of individuals with health problems. However, it is unclear whether autonomy support from healthcare providers affects health behaviour through self-efficacy and if patients' education level affects the association.
DESIGN
METHODS
A cross-sectional study.
METHODS
METHODS
A convenience sample of 207 individuals with one or more cardiovascular diseases completed self-administered surveys including the healthcare climate questionnaire, self-efficacy scale and the engagement in health behaviour scale. Data were analysed using descriptive statistics, t test, Pearson's correlation coefficients and hierarchical regression analysis. All procedures of the study adhered to the STROBE guidelines.
RESULTS
RESULTS
The influence of autonomy support from healthcare providers on self-efficacy differed by individuals' education level. Self-efficacy in less educated, but not highly educated individuals, tended to depend on the autonomy-supportive climate. Additionally, the autonomy-supportive healthcare climate affected health behaviour through self-efficacy only in less educated individuals.
CONCLUSION
CONCLUSIONS
The relationship between autonomy support from healthcare providers and self-efficacy was more evident in the relatively less educated individuals. The associations among autonomy support, self-efficacy and health behaviour differed by patient education level, and the mediating role of self-efficacy on the relationship between autonomy-supportive climate and health behaviour was found only in those less educated.
RELEVANCE TO CLINICAL PRACTICE
CONCLUSIONS
Healthcare providers should recognise the importance of supporting patients' need for autonomy to improve self-efficacy and healthy behaviour, particularly in less educated patients. Additionally, healthcare providers' support tailored to patients' needs and educational status should be highlighted.
Types de publication
Journal Article
Langues
eng
Pagination
1547-1556Subventions
Organisme : Chungnam National University Research Funds
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Bandura, A. (1986). Social foundations of thought and action (pp. 23-28). Prentice Hall; 1986.
Bandura, A. (1993). Perceived self-efficacy in cognitive development and functioning. Educational Psychologist, 28(2), 117-148.
Bandura, A. (2010). Self-efficacy. In: The Corsini encyclopedia of psychology 4th ed. (pp. 1534-1536). John Wiley & Sons.
Bohanny, W., Wu, S. F. V., Liu, C. Y., Yeh, S. H., Tsay, S. L., & Wang, T. J. (2013). Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. Journal of the American Association of Nurse Practitioners, 25(9), 495-502.
Curtin, R. B., Walters, B. A., Schatell, D., Pennell, P., Wise, M., & Klicko, K. (2008). Self-efficacy and self-management behaviors in patients with chronic kidney disease. Advances in Chronic Kidney Disease, 15(2), 191-205.
Deci, E. L., & Ryan, R. M. (2000). The" what" and" why" of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11(4), 227-268.
Deci, E. L., & Ryan, R. M. (2008). Self-determination theory: An approach to human motivation and personality. University of Rochester, NY, http://www.psych.rochester.edu/SDT/theory.html
Epstein, R. M., Alper, B. S., & Quill, T. E. (2004). Communicating evidence for participatory decision making. JAMA, 291(19), 2359-2366.
Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Publications.
Kim, H. S., & So, H. S. (2009). A prediction model development on quality of life in kidney transplant recipients. Journal of Korean Academy of Nursing, 39(4), 518-527.
Lorig, K., Ritter, P. L., Villa, F. J., & Armas, J. (2009). Community-based peer-led diabetes self-management. The Diabetes Educator, 35(4), 641-651.
Ng, J. Y., Ntoumanis, N., Thøgersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., & Williams, G. C. (2012). Self-determination theory applied to health contexts: A meta-analysis. Perspectives on Psychological Science, 7(4), 325-340.
Petrovic, D., de Mestral, C., Bochud, M., Bartley, M., Kivimäki, M., Vineis, P., Mackenbach, J., & Stringhini, S. (2018). The contribution of health behaviors to socioeconomic inequalities in health: A systematic review. Preventive Medicine, 113, 15-31.
Rimal, R. N. (2000). Closing the knowledge-behavior gap in health promotion: The mediating role of self-efficacy. Health Communication, 12(3), 219-237.
Robinson, S. A., Zocchi, M. S., Netherton, D., Ash, A., Purington, C. M., Connolly, S. L., Vimalananda, V. G., Hogan, T. P., & Shimada, S. L. (2020). Secure messaging, diabetes self-management, and the importance of patient autonomy: A mixed methods study. Journal of General Internal Medicine, 35, 2955-2962.
Senécal, C., Nouwen, A., & White, D. (2000). Motivation and dietary self-care in adults with diabetes: Are self-efficacy and autonomous self-regulation complementary or competing constructs? Health Psychology, 19(5), 452.
Slovinec D'Angelo, M. E., Pelletier, L. G., Reid, R. D., & Huta, V. (2014). The roles of self-efficacy and motivation in the prediction of short-and long-term adherence to exercise among patients with coronary heart disease. Health Psychology, 33(11), 1344.
Song, R., June, K. J., Kim, C. G., & Jeon, M. Y. (2004). Comparisons of motivation, health behaviors, and functional status among elders in residential homes in Korea. Public Health Nursing, 21(4), 361-371.
Song, H. Y., & Nam, K. A. (2015). Effectiveness of a stroke risk self-management intervention for adults with prehypertension. Asian nursing research, 9(4), 328-335.
Statistics Korea (2018). Explore Korea through Statistics 2018. http://kostat.go.kr/portal/eng/news/3/index.board
Sweet, S. N., Fortier, M. S., Strachan, S. M., Blanchard, C. M., & Boulay, P. (2014). Testing a longitudinal integrated self-efficacy and self-determination theory model for physical activity post-cardiac rehabilitation. Health Psychology Research, 2(1), 1008. https://doi.org/10.4081/hpr.2014.1008
Williams, G. C., Grow, V. M., Freedman, Z. R., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology, 70(1), 115.
Williams, G. C., Lynch, M., & Glasgow, R. E. (2007). Computer-assisted intervention improves patient-centered diabetes care by increasing autonomy support. Health Psychology, 26(6), 728.
Williams, G. C., McGregor, H. A., King, D., Nelson, C. C., & Glasgow, R. E. (2005). Variation in perceived competence, glycemic control, and patient satisfaction: Relationship to autonomy support from physicians. Patient Education and Counseling, 57(1), 39-45.
Williams, G. C., McGregor, H. A., Sharp, D., Levesque, C., Kouides, R. W., Ryan, R. M., & Deci, E. L. (2006). Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology, 25(1), 91.
World Health Organization (2016). Hearts: technical package for cardiovascular disease management in primary health care. https://www.who.int/cardiovascular_diseases/hearts/Hearts_package.pdf