The effect of self-efficacy expectations in the adherence to a gluten free diet in celiac disease

Abstract

The effect of self-efficacy expectations in the adherence to a gluten free diet in celiac disease Objective: To analyse the effect of general and specific self-efficacy on the adherence to a gluten free diet (GFD) in patients with celiac disease along with the effect of other relevant variables. Design: 271 patients with celiac disease participated in this transversal descriptive study and completed a series of questionnaires regarding adherence (CDAT), general self-efficacy (GSES) and specific self-efficacy (Celiac-SE) and CD-Qol, among others. Main outcome measures: Dependent variable was adherence to the Gluten Free Diet (GFD). Main independent variables were general self-efficacy, specific self-efficacy and quality of life. Model tests were conducted using regression analysis. Results: 71.9% of patients show an excellent or good adherence to the diet. Higher levels of adherence are positively associated to a high expectancy of specific self-efficacy, to the perceived adoption of recommended behaviours, risk perception and better quality of life (these variables accounted for 36.4 % of the variance in the adherence to a GFD, p<.001). Conclusions: Specific self-efficacy rather than general has a predictive value in adherence to a GFD. Therefore, we need to develop and transculturally adapt new instruments to assess specific self-efficacy. Celiac-SE has proved to be a useful scale for this objective.

Influence of Compliance to Diet and Self-Efficacy Expectation on Quality of Life in Patients with Celiac Disease in Spain

“…Adherence to a GFD was high in this study, with 68.7% of participants showing good or excellent adherence according to CDAT criteria [35], but somewhat lower than in previous research [27] conducted in Spain. This high adherence may be due to the fact that a large part of the sample (78.2%) is associated with a patient association [16,23,43] and, therefore, has a high level of knowledge about the disease with almost 10 years of average experience of the GFD.…”

“…This research shows that specific self-efficacy, adherence to the GFD as well as risk perception, time since diagnosis, and age play an important role in the HRQoL of patients with CD. Results show that it is self-efficacy, when specifically measured, that best predicts adherence to the GFD and the resulting HRQoL [27,39].…”

“…Based on our previous research [27], patients included in the study completed a 190 item questionnaire regarding sociodemographic data (age, gender, place of residency, education, occupational status), clinical data (previous symptoms and their intensity, age at diagnosis, time with symptoms before diagnosis, time since diagnosis), and GFD related issues (associated feelings, experiences, and perceptions), and scales regarding HRQoL, adherence to the GFD, and expectations of self-efficacy. Participants also answered questions regarding the perceived adoption of recommended behaviors and their perception of the risks associated with not following those recommendations.…”

“…Additionally, we evaluated, using two questionnaires, the perception of risks and the perceived adoption of the behaviors recommended when dealing with the GFD. These two questionnaires were developed from the content in the patients' association guide which was elaborated by experts [41], and previously used in our research [27,42]. The first questionnaire was the celiac disease risk assessment questionnaire (CDRAQ).…”

Is a Gluten-Free Diet Enough to Maintain Correct Micronutrients Status in Young Patients with Celiac Disease?

“…In general, patients with CD who participated in the present study were well controlled from a nutritional point of view, and the majority (86%) was aware of the dietary recommendations to be followed (strict GFD) and the performance of physical activity. It has been described that higher levels of adherence to a GFD are positively associated with the perceived adoption of healthy behaviors [42]. In fact, among our patients, it seems that low compliance could be related to a lack of nutritional knowledge and that over time they would acquire more information and there would be greater adherence to the GFD.…”