Raymond Mareeni, Iliffe Steve, Kharicha Kalpa, Harari Danielle, Swift Cameron, Gillmann Gerhard, Stuck Andreas E
Department of Primary Care and Population Sciences, University College London, Hampstead Campus, London, UK.
Prim Health Care Res Dev. 2011 Oct;12(4):348-56. doi: 10.1017/S1463423611000296. Epub 2011 Jul 21.
Enhancing self-efficacy is central to programmes promoting self-care and self-management. However, little is known about older people's self-efficacy in doctor-patient interactions. This paper investigates lifestyle, medical and demographic factors associated with self-efficacy in doctor-patient interactions in older people in general practice.
A cross-sectional analysis of data from a randomised controlled trial of older people was conducted in a health risk appraisal study in London. Self-efficacy was measured using the Perceived Efficacy in Patient-Physician Interactions Questionnaire.
Older people with higher self-efficacy were significantly more likely to report having had recent preventive care measures such as recent blood pressure measurement and influenza immunisation. Women were less likely to have higher self-efficacy than men. Older people were significantly less likely to have high self-efficacy if they reported having poor memory, low mood, limited activities due to fear of falling, basic education, difficulties with at least one activity of daily living, reduced physical activity, living alone, or risk of social isolation.
A third of people had low self-efficacy in doctor-patient interactions. They appear to be a vulnerable group. Low self-efficacy in interactions with doctors may be a symptom or a characteristic of older people who experience social isolation and depression. Policies that depend on enhancing self-care and self-management need to consider the large number of older people with low self-efficacy in using medical services, and understanding characteristics in older people associated with lower confidence in doctor-patient interactions may be useful in clinical practice and research.
提高自我效能是促进自我护理和自我管理项目的核心。然而，对于老年人在医患互动中的自我效能知之甚少。本文调查了全科医疗中与老年人医患互动自我效能相关的生活方式、医疗和人口统计学因素。
在伦敦的一项健康风险评估研究中，对一项针对老年人的随机对照试验的数据进行横断面分析。使用医患互动中的感知效能问卷来测量自我效能。
自我效能较高的老年人更有可能报告近期采取了预防保健措施，如近期测量血压和接种流感疫苗。女性自我效能较高的可能性低于男性。如果老年人报告记忆力差、情绪低落、因害怕跌倒而活动受限、接受过基础教育、至少一项日常生活活动有困难、体育活动减少、独居或有社会隔离风险，那么他们自我效能高的可能性显著降低。
三分之一的人在医患互动中自我效能较低。他们似乎是一个弱势群体。在与医生互动中自我效能低可能是经历社会隔离和抑郁的老年人的一种症状或特征。依赖于加强自我护理和自我管理的政策需要考虑到大量在使用医疗服务方面自我效能低的老年人，了解与医患互动中信心较低相关的老年人特征可能在临床实践和研究中有用。
