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土耳其东部癫痫患者的自我效能感、疾病相关恐惧与不确定性不耐受之间的关系:一项路径分析。

The relationship between self-efficacy, illness-related fear, and intolerance of uncertainty in patients who have epilepsy in eastern Türkiye: A path analysis.

作者信息

Erden Yasemin, Turan Gülcan Bahçecioğlu, Karakurt Nurgul, Bakır Ercan

机构信息

Erzurum Technical University, Faculty of Health Sciences, Nursing Department, Turkey.

Fırat University, Faculty of Health Sciences, Nursing Department, Turkey.

出版信息

Epilepsy Behav. 2025 Jun;167:110367. doi: 10.1016/j.yebeh.2025.110367. Epub 2025 Mar 24.

Abstract

BACKGROUND

The effects of psychological factors such as self-efficacy, illness-related fear, and intolerance of uncertainty on illness management and quality of life of patients who have epilepsy have important roles in understanding the health behaviors of individuals.

AIM

The present study was conducted to examine the relationship between self-efficacy, illness-related fear, and intolerance of uncertainty in patients who have epilepsy and to investigate the mediating role of illness-related fear in the relationship between self-efficacy and intolerance of uncertainty.

METHOD

This cross-sectional and correlational study had a descriptive design and was conducted with 150 epilepsy patients who met the inclusion criteria and applied to the neurology clinic of a university hospital. The study population comprised epilepsy patients who applied to the Neurology Clinic of a university hospital in eastern Türkiye between May 2024 and August 2024. The data were collected by using the Personal Information Form, Epilepsy Self-Efficacy Scale, Illness-Related Fear Scale, and Mishel Uncertainty in Illness Scale - Community Form. The Structural Equation Modeling and Bootstrapping Methods were used to analyze the study data. The study was reported following the STROBE Recommendations.

RESULTS

Based on the findings, self-efficacy was found to negatively affect intolerance of uncertainty about the illness (b = -0.384, 95 % CI [-0.462 to -0.306], p < 0.01) and illness-related fear (b = -0.449, 95 % CI [-0.544 to -0.344], p < 0.01). Also, illness-related fear was found to positively affect intolerance of uncertainty (b = 0.688, 95 % CI [0.586 to 0.789], p < 0.01). The indirect effect of self-efficacy on intolerance of uncertainty through illness-related fear (b = -0.309, 95 % CI [-0.444 to -0.210], p < 0.01) was found to be negative and significant and the total effect (b = -0.693, 95 % CI [-0.789 to -0.597], p < 0.01) was also negative and significant. Self-efficacy explained 34 % of the illness-related fear and 59 % of the total intolerance of uncertainty in the model. The estimated effects were calculated with 5000 repeated operations and were evaluated to be significant because the indirect effects did not include zero in the 95 % Confidence Interval.

CONCLUSION

The results of the present study showed that self-efficacy has a direct negative impact on intolerance of uncertainty in patients who have epilepsy and that fear related to the illness plays mediating roles in this effect.

摘要

背景

自我效能感、疾病相关恐惧和不确定性不耐受等心理因素对癫痫患者的疾病管理和生活质量的影响,在理解个体健康行为方面具有重要作用。

目的

本研究旨在探讨癫痫患者的自我效能感、疾病相关恐惧和不确定性不耐受之间的关系,并研究疾病相关恐惧在自我效能感与不确定性不耐受关系中的中介作用。

方法

本横断面相关性研究采用描述性设计,对150名符合纳入标准并到某大学医院神经科就诊的癫痫患者进行研究。研究对象为2024年5月至2024年8月期间到土耳其东部某大学医院神经科就诊的癫痫患者。通过使用个人信息表、癫痫自我效能量表、疾病相关恐惧量表和米舍尔疾病不确定性量表-社区版收集数据。采用结构方程模型和Bootstrapping方法分析研究数据。本研究按照STROBE建议进行报告。

结果

基于研究结果,发现自我效能感对疾病不确定性不耐受(b = -0.384,95%CI[-0.462至-0.306],p < 0.01)和疾病相关恐惧(b = -0.449,95%CI[-0.544至-0.344],p < 0.01)有负面影响。此外,发现疾病相关恐惧对不确定性不耐受有正面影响(b = 0.688,95%CI[0.586至0.789],p < 0.01)。自我效能感通过疾病相关恐惧对不确定性不耐受的间接效应(b = -0.309,95%CI[-0.444至-0.210],p < 0.01)被发现为负面且显著,总效应(b = -0.693,95%CI[-0.789至-0.597],p < 0.01)也为负面且显著。在模型中,自我效能感解释了34%的疾病相关恐惧和59%的总不确定性不耐受。估计效应通过5000次重复运算计算得出,由于间接效应在95%置信区间中不包括零,因此评估为显著。

结论

本研究结果表明,自我效能感对癫痫患者的不确定性不耐受有直接负面影响,且与疾病相关的恐惧在这种影响中起中介作用。

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