Lau-Walker Margaret
University of Surrey, Surrey, UK.
Br J Health Psychol. 2006 Nov;11(Pt 4):643-61. doi: 10.1348/135910705X72802.
To assess the measures of illness representation components in predicting measures of self-efficacy in patients with coronary heart disease.
A longitudinal design was adopted with predictor variables and dependent variables (general self-efficacy, diet self-efficacy and exercise self-efficacy) measured twice while participants were in hospital and 9 months following discharge. Change scores of the predictor variables can be calculated and dependent variables at baseline can be controlled.
A cohort sample of 300 patients admitted to hospital with coronary heart disease were given the questionnaire measuring their illness perception (illness representation components: identity, consequences, timeline and control/cure and outcome expectation for diet and exercise); self-efficacy (general, diet and exercise self-efficacy measures), demographic and illness characteristics and attendance on a cardiac rehabilitation programme. The patients were asked to complete the questionnaire in hospital before discharge following their cardiac diagnosis, and again, 9 months later, when participants were expected to be functioning independently of any rehabilitation programme.
Demographic and illness characteristics were found to have a more significant relationship with illness representation components than with specific self-efficacy. The relationship between illness representation components and specific self-efficacy changes overtime, consequence and timeline were significantly related to self-efficacy measures initially; however, symptom and control/cure were the variables that were significantly related to self-efficacy measures 9 months later. After statistically controlling individuals' baseline self-efficacy measures, demographic and illness characteristic effects, symptom and control/cure were found to make significant contributions to exercise and diet self-efficacy, respectively, 9 months later.
A significant relationship exists between illness representation and self-efficacy. There is potential to integrate both approaches to the assessment of psychosocial factors to provide effective individualized care in cardiac rehabilitation.
评估冠心病患者疾病表征成分的测量指标对自我效能测量指标的预测作用。
采用纵向设计,在参与者住院期间和出院后9个月对预测变量和因变量(一般自我效能、饮食自我效能和运动自我效能)进行两次测量。可以计算预测变量的变化分数,并控制基线时的因变量。
对300例因冠心病入院的患者进行队列抽样,让他们填写问卷,测量其疾病认知(疾病表征成分:同一性、后果、时间线以及饮食和运动的控制/治愈和结果期望);自我效能(一般、饮食和运动自我效能测量指标)、人口统计学和疾病特征以及心脏康复项目的参与情况。要求患者在心脏病诊断后出院前在医院完成问卷,9个月后再次填写,此时预计参与者已独立于任何康复项目。
发现人口统计学和疾病特征与疾病表征成分的关系比与特定自我效能的关系更显著。疾病表征成分与特定自我效能之间的关系随时间变化,后果和时间线最初与自我效能测量指标显著相关;然而,症状和控制/治愈是9个月后与自我效能测量指标显著相关的变量。在对个体的基线自我效能测量指标、人口统计学和疾病特征效应进行统计学控制后,发现症状和控制/治愈分别在9个月后对运动和饮食自我效能有显著贡献。
疾病表征与自我效能之间存在显著关系。有可能整合这两种评估心理社会因素的方法,以在心脏康复中提供有效的个性化护理。