Basic Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hypertens. Dec 12, 2019; 9(3): 30-41
Published online Dec 12, 2019. doi: 10.5494/wjh.v9.i3.30
Self-efficacy for managing hypertension and comorbid conditions
Mi Jung Lee, Sergio Romero, HuanGuang Jia, Craig A Velozo, Ann L Gruber-Baldini, Lisa M Shulman
Mi Jung Lee, Sergio Romero, Department of Occupational Therapy, University of Florida, Gainesville, FL 32610, United States
Mi Jung Lee, Sergio Romero, Huan-Guang Jia, NF/SG VHS, Center of Innovation on Disability and Rehabilitation Research-GNV, Gainesville, FL 32601, United States
Craig A Velozo, Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC 29425, United States
Ann L Gruber-Baldini, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, United States
Lisa M Shulman, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, United States
Author contributions: Lee M and Romero S designed the study, analyzed the data, and wrote the manuscript; Jia H, Velozo CA, Gruber-Baldini AL, and Shulman LM assisted with conceptualizing the manuscript and provided critical feedback; All authors have read and approve the final manuscript.
Supported by National Institutes of Health, No. 1U01AR057967-01.
Conflict-of-interest statement: All authors declare no potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sergio Romero, PhD, Research Scientist, Department of Occupational Therapy, University of Florida, 1329 SW 16th Street, Gainesville, FL 32610, United States. sromero@phhp.ufl.edu
Received: July 11, 2019
Peer-review started: July 16, 2019
First decision: August 7, 2019
Revised: September 4, 2019
Accepted: November 26, 2019
Article in press: November 26, 2019
Published online: December 12, 2019
Processing time: 160 Days and 5.7 Hours
Abstract
BACKGROUND

Self-efficacy is defined an individual’s belief in completing necessary actions to achieve the desired goal. For individuals with hypertension and other chronic conditions, self-efficacy has been an essential factor to predict adherence to treatment behaviors.

AIM

To examine self-efficacy for managing chronic conditions in individuals with hypertension.

METHODS

A total of 1087 individuals with chronic conditions in two groups (hypertension and non-hypertension groups) were selected in this study. The two groups’ self-efficacy for managing chronic conditions were investigated using the five domains of patient reported outcomes measurement information system self-efficacy for managing chronic conditions measures (PROMIS-SE); daily activities, emotions, medication and treatment, social interactions, and symptoms. Also, the relationships between self-efficacy and other health-related outcomes for the hypertension group were examined using structural equation modeling.

RESULTS

Among 1087 participants, 437 reported having hypertension. The hypertension and non-hypertension groups were statistically different in self-efficacy for managing daily activities [F (1, 598) = 5.63, P < 0.05]. Structural equation modeling indicated that for individuals with hypertension, two domains of PROMIS-SE (managing daily activities and emotions) significantly predict global physical health (P < 0.001 and P < 0.01 sequentially), and one domain (managing emotions) significantly predicts mental health (P < 0.001). Hypertension patients’ general quality of life was significantly predicted by global physical health (P < 0.001) and mental health (P < 0.001).

CONCLUSION

The hypertension group reported deficits in self-efficacy in managing daily activities as compared to the non-hypertension group. In this hypertension group, self-efficacy functioned as an indirect predictor of general quality of life, mediated by global physical and mental health.

Keywords: Hypertension; Self-efficacy; Self-management; Chronic conditions

Core tip: Self-efficacy is an essential factor for predicting treatment adherence, but individuals with hypertension report deficits in self-efficacy for managing hypertension and other comorbid conditions. This study compared self-efficacy for managing chronic conditions between patients with hypertension and patients with other chronic conditions. Also, structural relationships of self-efficacy for managing hypertension and comorbid conditions with other health-related outcomes were examined. This study indicates that deficits in self-efficacy is particularly true for self-efficacy in managing daily activities. Self-efficacy functions as an indirect factor, mediated by global physical and mental health, to predict quality of life.