Exploring the Contribution of General Self-Efficacy to the Use of Self-Care Symptom Management Strategies by People Living with HIV Infection

Abstract

General self-efficacy (GSE), the expectation that one is able to perform a behavior successfully, may differentiate those who are able to successfully utilize self-care symptom management strategies (SCSMS). This subanalysis (n=569) of an international 12 site longitudinal randomized controlled trial (RCT) (n=775), investigated GSE as an important factor determining symptom burden, SCSMS, engagement with the provider, and medication adherence over time, and identified differences in those with high and low GSE ratings concerning these variables. Parametric and nonparametric repeated-measures tests were employed to assess GSE and the perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, nausea, and neuropathy. Symptom burden, engagement with the provider, and antiretroviral adherence were analyzed with regard to GSE. Our data indicated that there were differences in the perceived symptom burden over time of HIV infected individuals by GSE. Those individuals with higher GSE had fewer symptoms and these symptoms were perceived to be less intense than those experienced by the low GSE group. There were few meaningful differences in the SCSMS used by those with high versus low GSE other than the use of illicit substances in the low GSE group. The low GSE group was also significantly (p= < 0.001) less engaged with their healthcare providers. Given the difference in substance use by perceived GSE, and the importance of engagement with the healthcare provider, more attention to the resolution of the concerns of those with low GSE by healthcare providers is warranted.

Requesting Help to Understand Medical Information Among People Living with HIV and Poor Health Literacy

“…Other factors that were not assessed in the current study that may have also impacted the results are personality characteristics such as conscientiousness, locus of control, general self-efficacy, and social orientations such as introversion and extroversion. 29 Although we predicted that requesting assistance with reading and interpreting health information would compensate for the challenges experienced by those with the lowest literacy skills, our results found the opposite; people who requested assistance remained the least adherent and had the poorest health outcomes. Poorer adherence among those who requested informational assistance occurred despite their reporting greater use of every adherence improvement strategy we assessed.…”

Self‐Efficacy Among Adults in Substance Abuse Treatment: The Role of Religious Coping

“…Previous researchers have established support for the notion that general self‐efficacy corresponds to positive outcomes with regard to substance abuse (Corless et al, ; Hassel et al, ; Mittag & Schwarzer, ). Religiousness is a potential predictor of general self‐efficacy; however, religiousness can be measured in various ways.…”

“…Beyond the established associations between GSE and lowered substance use (Corless et al, ; Hassel et al, ; Mittag & Schwarzer, ), GSE relates to other desirable outcomes such as quality of life (Ponizovsky et al, ), active coping and positive reframing (Luszczynska et al, ), and proactive attitudes (Albion, Fernie, & Burton, ). In light of the potential benefits associated with GSE, it is important to identify predictors of GSE.…”

“…Specifically, among adult men, Mittag and Schwarzer () determined that those with low general self‐efficacy had higher alcohol consumption than those with high general self‐efficacy. Among individuals with HIV, Corless et al () found those with low general self‐efficacy engaged in higher levels of substance abuse. In addition, Hassel, Nordfjærn, and Hagen () described a significant, inverse relationship between general self‐efficacy and illicit drug use as well as alcohol use.…”

Health Care Customer Creativity

“…Self-efficacy has been commonly addressed as a factor that influences the individual's engagement with medical treatment (e.g., Williams and Manias 2014;Corless et al 2012;Snell and White 2011;Cameron et al 2010;Boyne et al 2014). Self-efficacy refers to an individual's capacity to execute behaviors necessary to the specific situation (Bandura 1977).…”