Grembowski D, Patrick D, Diehr P, Durham M, Beresford S, Kay E, Hecht J
Department of Health Services, University of Washington, Seattle 98195.
J Health Soc Behav. 1993 Jun;34(2):89-104.
Self-efficacy has a well-established, beneficial effect on health behavior and health status in young and middle-aged adults, but little is known about these relationships in older populations. We examined this issue as part of a randomized trial to determine the cost savings and changes in health-related quality of life associated with the provision and reimbursement of a preventive services package to 2,524 Medicare beneficiaries enrolled in Group Health Cooperative of Puget Sound. Baseline self-efficacy data were collected for all participants in five behavioral areas: exercise, dietary fat intake, weight control, alcohol intake, and smoking. Results reveal that efficacy and outcome expectations for these health behaviors are not independent. Correlational and factor analyses indicate two dimensions of efficacy expectations, one consisting of exercise, dietary fat, and weight control, and another consisting of smoking and alcohol consumption. Outcome expectations of the five behaviors form a single dimension. Older adults with high self-efficacy had lower health risk in all behaviors and better health. Regression analyses detected a positive association between socioeconomic status and health-related quality of life (p < .02), but the strength of the association declined (p < .11) after the self-efficacy measures entered the model, indicating that self-efficacy explains part of the association between socioeconomic status and health status. Interventions aimed at improving self-efficacy also may improve health status.
自我效能感对中青年的健康行为和健康状况具有公认的有益影响，但对于老年人群体中这些关系的了解却很少。作为一项随机试验的一部分，我们研究了这个问题，该试验旨在确定为普吉特海湾健康合作组织登记的2524名医疗保险受益人提供预防性服务包并给予报销后所节省的成本以及与健康相关的生活质量的变化。为所有参与者收集了五个行为领域的基线自我效能感数据：运动、膳食脂肪摄入、体重控制、酒精摄入和吸烟。结果显示，这些健康行为的效能感和结果期望并非相互独立。相关分析和因子分析表明效能期望有两个维度，一个由运动、膳食脂肪和体重控制组成，另一个由吸烟和饮酒组成。这五种行为的结果期望形成一个单一维度。自我效能感高的老年人在所有行为中的健康风险较低，健康状况较好。回归分析发现社会经济地位与健康相关生活质量之间存在正相关（p < .02），但在自我效能感测量指标进入模型后，这种关联的强度下降了（p < .11），这表明自我效能感解释了社会经济地位与健康状况之间关联的一部分。旨在提高自我效能感的干预措施也可能改善健康状况。
