Shrestha Rabina, Rawal Lal, Bajracharya Rashmita, Ghimire Anup
Dhulikhel Hospital Kathmandu University Hospital, Kathmandu, Nepal.
School of Health, Medical and Applied Sciences, Central Queensland University, Sydney Campus, Sydney, Australia.
J Public Health Res. 2020 Dec 23;9(4):1787. doi: 10.4081/jphr.2020.1787. eCollection 2020 Oct 14.
Cardiac self-efficacy determines how people feel, think, motivate themselves and behave with regards to improving their cardiac health subsequently preventing complications of coronary artery disease (CAD). Given almost one-third of global death is contributed by CAD with 10% of disability adjusted life years lost in low- and middle-income countries (including Nepal), it is important to identify factors that can promote cardiac self-efficacy. There are no studies in Nepal focusing on predictors of self-efficacy. Therefore, we aim to determine the predictors of cardiac self-efficacy of CAD patients in Nepal. This is a cross-sectional study where we recruited 170 patients (≥30 years) diagnosed with CAD from two tertiary level hospitals. Multiple linear regression model was used to identify the predictors of cardiac self-efficacy. The mean age of the participants was 60.45±10.39 years (range, 31-83). Most of the participants were diagnosed as myocardial infarction (91.2%), rest with unstable angina (6.5%) and stable angina (2.4%). The multivariate analysis shows age (p<0.001), health behaviors (p<0.001) and knowledge of the disease (p<0.001) were statistically significant predictors to cardiac self-efficacy. Every 1-year increase in age was associated with 0.23 units increase in cardiac self-efficacy score. Similarly, every unit increase in health behavior score and knowledge of disease score was associated with 0.432 units and 0.475 units increase in cardiac self-efficacy score respectively. Age and health behaviors were the strongest predictors of cardiac self-efficacy followed by knowledge of the disease. We conclude that those with poor health behavior are at a greater risk of poorer cardiac self-efficacy compared to those with relatively good level of self-efficacy. Public health interventions such as awareness raising about cardiac disease and health behavior modification along with early screening, diagnosis and appropriate care are essential to improving self-efficacy and cardiac care outcomes.
心脏自我效能决定了人们在改善心脏健康以及预防冠状动脉疾病（CAD）并发症方面的感受、思维方式、自我激励方式和行为表现。鉴于全球近三分之一的死亡由CAD导致，在低收入和中等收入国家（包括尼泊尔）有10%的残疾调整生命年损失，因此识别能够促进心脏自我效能的因素非常重要。尼泊尔尚无专注于自我效能预测因素的研究。因此，我们旨在确定尼泊尔CAD患者心脏自我效能的预测因素。这是一项横断面研究，我们从两家三级医院招募了170名（≥30岁）被诊断为CAD的患者。采用多元线性回归模型来识别心脏自我效能的预测因素。参与者的平均年龄为60.45±10.39岁（范围为31 - 83岁）。大多数参与者被诊断为心肌梗死（91.2%），其余为不稳定型心绞痛（6.5%）和稳定型心绞痛（2.4%）。多变量分析显示年龄（p<0.001）、健康行为（p<0.001）和疾病知识（p<0.001）是心脏自我效能的统计学显著预测因素。年龄每增加1岁，心脏自我效能得分增加0.23个单位。同样，健康行为得分和疾病知识得分每增加1个单位，心脏自我效能得分分别增加0.432个单位和0.475个单位。年龄和健康行为是心脏自我效能最强的预测因素，其次是疾病知识。我们得出结论，与自我效能水平相对较好的人相比，健康行为较差的人心脏自我效能较差的风险更大。诸如提高对心脏病的认识、改变健康行为以及早期筛查、诊断和适当护理等公共卫生干预措施对于提高自我效能和心脏护理结果至关重要。
