Self-management behaviors in adults with chronic hepatitis B: A structural equation model

Kong, Lingna; Zhu, Wenfen; Li, Lin; Lei, Qingsong; Wang, Tian; Li, Yilan

doi:10.1016/j.ijnurstu.2019.06.013

Cited by 19 publications

(27 citation statements)

References 34 publications

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“…In addition, self-efficacy was also an important predictor of medication adherence in patients with T2D, which was in line with previous studies showing that self-efficacy was positively correlated with medication adherence in patients with hypertension, HIV and diabetes ( 23 , 25 , 26 ). Patients with high self-efficacy may be more confident of good health outcomes resulting from medication adherence and thus more likely to adhere to medication ( 53 ). Moreover, self-efficacy was also a mediating variable in the influence of neuroticism and social support on medication adherence in patients with T2D in the final model.…”

Section: Discussionmentioning

confidence: 99%

Medication Adherence and Associated Factors in Patients With Type 2 Diabetes: A Structural Equation Model

Huang

Ding

Xiong

et al. 2021

Front. Public Health

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Background: The number of patients with type 2 diabetes (T2D) is increasing. Medication treatment is of great importance to stabilize blood glucose. Previous studies have reported that neuroticism, self-efficacy, and social support are factors associated with medication adherence, but few studies have fully investigated the mechanisms between these factors and medication adherence in patients with T2D.Purpose: To explore the prevalence of medication adherence and the factors associated with medication adherence in patients with T2D.Methods: A cross-sectional study consisting of 483 patients with T2D was conducted from July to December 2020. Questionnaires containing sociodemographic and clinical characteristics, the Morisky Medication Adherence Scale-8 (MMAS-8), the neuroticism subscale of the Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Diabetes Management Self-efficacy Scale (DMSES) were used to collect data. The structural equation model (SEM) was used to test the hypotheses.Results: This study included 305 (63.1%) medication adherence and 178 (36.9%) medication non-adherence patients with T2D. Social support directly influenced medication adherence (β = 0.115, P = 0.029) and indirectly influenced medication adherence through self-efficacy (β = 0.044, P = 0.016). Self-efficacy directly influenced medication adherence (β = 0.139, P = 0.023). Neuroticism indirectly affected medication adherence through social support (β = −0.027, P = 0.023) and self-efficacy (β = −0.019, P = 0.014). Moreover, there was a sequential mediating effect of social support and self-efficacy on the relationship between neuroticism and medication adherence (β = −0.010, P = 0.012). After controlling for age and gender, similar results were obtained. The model fit indices showed a good fit.Conclusions: The medication adherence of patients with T2D needs to be improved. Neuroticism, social support, and self-efficacy had direct or indirect effects on medication adherence in patients with T2D. Healthcare providers should comprehensively develop intervention programs based on neuroticism, social support, and self-efficacy to improve medication adherence in patients with T2D.

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Section: Discussionmentioning

confidence: 99%

Medication Adherence and Associated Factors in Patients With Type 2 Diabetes: A Structural Equation Model

Huang

Ding

Xiong

et al. 2021

Front. Public Health

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“…The total score ranged from 10 to 66, with higher scores indicating higher levels of social support. The scale showed reasonable internal consistency (Cronbach’s α = 0.89) and test-retest reliability (Cronbach’s α = 0.92) [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis

Wen

Wang

et al. 2022

BMC Public Health

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Background Chronic non-communicable diseases (CNCDs) are an urgent public health issue in China, especially among older adults. Hence, self-management is crucial for disease progression and treatment. Electronic health (e-health) literacy and self-efficacy positively correlate with self-management. However, we know little about their underlying mechanisms in older adults with CNCDs. Objective To explore the factors that influence chronic disease self-management (CDSM) and verify self-efficacy as the mediator between e-health literacy and self-management behavior in older patients with CNCDs. Methods This cross-sectional study included 289 older patients with CNCDs from Hunan province, China, between July and November 2021. E-health literacy, self-efficacy, social support, and CDSM data were collected through questionnaires. The influence of each factor on CDSM was explored with multiple linear regression analysis. Intermediary effects were computed via a structural equation model. Results The total CDSM score in the patients was 29.39 ± 9.60 and only 46 (15.92%) patients used smart healthcare devices. The regression analysis showed e-health literacy, self-efficacy, and social support were the factors that affected CDSM. Furthermore, the structural equation model revealed that self-efficacy directly affected CDSM (β = 0.45, P < 0.01), whereas e-health literacy affected it directly (β = 0.42, P < 0.01) and indirectly (β = 0.429, P < 0.01) through self-efficacy. Conclusions This study revealed that self-management among older patients with CNCDs is at a low level, and few of them use smart healthcare devices. Self-efficacy plays a partial intermediary role between e-health literacy and self-management in older patients with CNCDs. Thus, efforts to improve their CDSM by targeting e-health literacy may be more effective when considering self-efficacy.

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“…Self‐management has been demonstrated to have positive effects on medication adherence, clinical outcomes and quality of life for people with chronic conditions (Grady & Gough, 2014). Despite the importance of self‐management, patient with CHB showed insufficient self‐management behaviours, such as low adherence to antiviral drugs and abstaining from alcohol (Kong et al., 2019; Lin et al., 2015). Some factors were found to influence self‐management behaviours in patients with CHB, such as self‐efficacy, social support, family roles, and cultural beliefs about health care (Kong et al., 2019; Lin & Lee, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Despite the importance of self‐management, patient with CHB showed insufficient self‐management behaviours, such as low adherence to antiviral drugs and abstaining from alcohol (Kong et al., 2019; Lin et al., 2015). Some factors were found to influence self‐management behaviours in patients with CHB, such as self‐efficacy, social support, family roles, and cultural beliefs about health care (Kong et al., 2019; Lin & Lee, 2019). However, little is known about the effect of psychological distress on self‐management activities among patients with CHB.…”

Section: Introductionmentioning

confidence: 99%

Psychological distress and self‐management behaviours among patients with chronic hepatitis B receiving oral antiviral therapy

Kong

et al. 2020

Journal of Advanced Nursing

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Aims To assess the prevalence and associated factors of psychological distress among patients with chronic hepatitis B receiving oral antiviral therapy and explore the association between psychological distress and self‐management behaviours among this population. Design A cross‐sectional study. Methods A convenience sample of 188 patients with chronic hepatitis B receiving oral antiviral therapy was recruited from March‐October 2018 to complete a self‐report questionnaire including the Chinese version of Depression Anxiety Stress Scale‐21 and Chronic Hepatitis B Self‐Management Scale. Logistic regression analysis and hierarchical multiple regression analysis were used to determine the factors associated with psychological distress and the association between psychological distress and self‐management behaviours respectively. Results The prevalence of depression, anxiety, and stress symptoms were 33.0%, 38.3% and 17.6% respectively. Depression was associated with older age, female gender, lower education level and longer treatment duration; anxiety was associated with female gender and longer treatment duration; and stress was associated with age of 31–40 years, female gender and unmarried status. There were significant associations between depression and anxiety symptoms and self‐management behaviours. Conclusion Psychological distress was prevalent among patients with chronic hepatitis B receiving oral antiviral therapy and had a negative impact on self‐management. Interventions targeting depression and anxiety symptoms may be beneficial to improve self‐management behaviours for this population. Impact This study explored the factors associated with psychological distress in patients with chronic hepatitis B receiving oral antiviral therapy. The findings showed psychological distress was more common in patients who were with older age, female, less educated, unmarried and receiving longer duration of treatment and psychological distress was significantly associated with self‐management behaviours. Nurses and other healthcare providers should provide interventions to reduce the risk of psychological distress and improve self‐management behaviours for this population.

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Self-management behaviors in adults with chronic hepatitis B: A structural equation model

Cited by 19 publications

References 34 publications

Medication Adherence and Associated Factors in Patients With Type 2 Diabetes: A Structural Equation Model

Medication Adherence and Associated Factors in Patients With Type 2 Diabetes: A Structural Equation Model

Associations between e-health literacy and chronic disease self-management in older Chinese patients with chronic non-communicable diseases: a mediation analysis

Psychological distress and self‐management behaviours among patients with chronic hepatitis B receiving oral antiviral therapy

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