老年知识分子再创造自我效能感的调查研究

目的　研究老年知识分子再创造自我效能感。方法　使用自编问卷以某师范大学和老年大学为被试进行调查。结果　老年知识分子再创造者和未再创造者在自我效能感的多个维度上存在显著差异 ,兴趣爱好对再创造自我效能感的影响最大。结论　老年知识分子再创造者自我效能感比未再创造者高 ,而影响再创造自我效能感最大的因素是兴趣爱好。     

社区老年人孤独感、自我效能与家庭支持

目的研究社区老年人孤独感、自我效能感及家庭支持功能的现状及其相互关系。方法采用孤独量表、自我效能感量表及家庭关怀度量表对社区老人进行测评。结果不同年龄段老年人的孤独感存在显著性差异(P<0.05)。不同性别老年人的孤独感及自我效能感存在显著性差异(P<0.05)。老年人孤独感与一般自我效能感、家庭功能呈显著负相关(P<0.01)。老年人一般自我效能感与家庭功能呈显著正相关(P<0.05)。结论提高老年人的自我效能感和家庭支持度可减少孤独感的产生。     

临床护理带教老师自我效能感、职业压力与带教行为的关系研究

目的探讨临床护理带教老师自我效能感、职业压力与带教行为的关系。方法选取我院临床护理带教老师77名为研究对象,采用一般自我效能量表、职业压力源量表及临床带教行为问卷进行调查,分析临床护理带教老师自我效能感、职业压力与带教行为之间的关系。结果77名老师一般自我效能感得分及带教行为总均分分别为(2.69±0.60)分、(4.36±0.48)分,职业压力源总均分为(3.88±0.21)分;临床护理带教老师带教行为与自我效能感呈正相关,与职业压力呈负相关。结论临床护理带教老师职业压力越大、自我效能感越高,带教行为越差。对临床带教老师进行自我效能感评分及职业压力分析,采取相应措施,可提高老师的自我效能感,减轻职业压力,改善带教行为,保障教学质量。     

老年腰椎间盘突出症患者自我效能水平及其影响因素

目的了解老年腰椎间盘突出症(LDH)患者慢性疼痛自我效能状况,探讨其影响因素。方法选取2018年3月至2018年12月西安市3所医院收治的拟进行髓核摘除、植骨融合内固定手术治疗的老年LDH患者231例。应用慢性疼痛自我效能感量表、焦虑自评量表、患病行为问卷、视觉模拟评分表为研究工具进行调查。采用SPSS 17.0软件进行统计分析。采用多元线性逐步回归分析筛选自我效能感的影响因素。结果老年LDH患者慢性疼痛自我效能得分为41～74(60.33±8.88)分;在3个维度的条目均分中,疼痛管理自我效能感维度得分最高(3.05±0.46)分,躯体功能自我效能维度得分最低(2.63±0.35)分。多元线性逐步回归分析显示,焦虑、患病行为水平、腰腿疼痛程度、合并慢性病、文化程度与老年LDH患者自我效能水平密切相关(P0.05)。结论老年LDH患者的慢性疼痛自我效能感整体处于中等水平,疼痛管理自我效能感水平最高,躯体功能自我效能感最低;焦虑、患病行为、腰腿疼痛、合并慢性病是老年LDH患者慢行疼痛自我效能感的危险因素,而高文化水平是其保护因素。     

绵阳市年轻男男性行为者一般自我效能感及影响因素分析

目的了解年轻男男性行为者(YMSM)一般自我效能感现状,分析影响因素。方法用"滚雪球"抽样法,对四川省绵阳市YMSM进行一般自我效能感等问卷调查和血清学检测。结果有效问卷337份,一般自我效能感平均(2.52±0.542)分,HIV、梅毒检测是否阳性的一般自我效能感得分差异无统计学意义(P均0.05)。多因素分析显示:文化程度、外省户籍、月收入、近1年接受预防服务、近6个月知晓性伴健康、近6个月肛交安全套使用频率与一般自我效能感得分呈正相关,近6个月肛交人数、近6个月与女性间的性行为与一般自我效能感得分呈负相关(P均0.05)。结论 YYMSM一般自我效能感较低,自我效能感受多种因素影响,提高其自我效能感对降低高危行为作用明显,对艾滋病防治具重要性。     

资源和SOC生活管理策略对老年人主观幸福感的影响

目的探讨自我效能感在老年人的资源、自评量表操纵圈(SOC)生活管理策略和主观幸福感间的中介作用。方法采用SOC问卷、资源量表、自我效能感量表和纽芬兰纪念大学幸福度量表对130位老人施测。结果在回归方程中,资源、SOC生活管理策略分别解释了主观幸福感变异的30%、32%(P0.01),当自我效能感也分别进入后,资源、自我效能感以及SOC、自我效能感对主观幸福感的解释量均增至40%、ΔR2=0.10、ΔR2=0.09;社会支持因素和补偿策略与主观幸福感的相关较高,分别为0.48、0.55。结论社会支持和补偿策略显著影响自我效能感和主观幸福感;自我效能感对主观幸福感有显著影响;自我效能感在资源和SOC生活管理策略对主观幸福感的影响中起到了部分中介作用。     

老年人的一般自我效能感与心理健康

目的 了解一般自我效能感的年龄差异以及一般自我效能感与心理健康水平之间关系的年龄特征.方法 采用方便取样的方法对48名城市社区老年人和49名在校大学生进行了测查.运用MACOVA分析、t检验、相关分析和回归分析对数据进行统计处理.结果 老年女性的一般自我效能感和心理健康水平得分显著高于年轻女性;无论年轻人还是老年人,一般自我效能感与心理健康均存在显著正相关,但相关系数不存在显著年龄差异;年轻人的一般自我效能感对心理健康水平变异的解释率大于老年人.结论 一般自我效能感和心理健康水平的年龄特征呈现性别的偏向性,而一般自我效能感与心理健康的相关关系的年龄特征不明显.     

HIV/AIDS患者治疗依从性自我效能感及相关因素

目的 调查HIV/AIDS患者治疗依从性自我效能感及其相关因素。方法 于2022年5-7月采用方便抽样法纳入杭州某传染病医院感染科门诊840例HIV/AIDS患者作为研究对象,调查内容包括社会人口学特征、生活习惯、疾病相关资料、焦虑抑郁、睡眠障碍、治疗依从性自我效能等,通过多元逐步回归分析影响治疗依从性自我效能感维度1融合和维度2毅力的因素。结果 840例HIV/AIDS患者治疗依从性自我效能感较好,治疗依从性自我效能感总分为（111.07±14.54）分,维度1融合评分为（55.44±7.86）分,维度2毅力评分为（55.63±7.61）分。多元逐步回归分析显示,抑郁与HIV/AIDS患者治疗依从性自我效能感维度1融合（β=-0.455,P<0.001）和维度2毅力（β=-0.445,P<0.001）相关。全身慢性疼痛（β=-3.020,P<0.05）、基线CD4细胞计数（β=-0.580,P<0.05）与治疗依从性自我效能感维度2毅力相关。结论 改善HIV/AIDS患者抑郁、疼痛等不适症状可以提高HIV/AIDS患者治疗依从性自我效能。     

结核病患者病耻感的研究进展

病耻感是患者因患病而产生的一种负性情绪体验。由于结核病患者缺乏疾病知识及公众对结核病患者的歧视态度,病耻感在结核病患者中广泛存在,并严重影响着患者的身心健康。结核病患者病耻感已受到国外学者的关注,并已编制出多个针对结核病患者病耻感的测评工具,其中使用范围最广的是由Van等编制的结核病相关病耻感量表。结核病患者病耻感水平与患者的性别、居住地、文化程度、婚姻状况、家庭收入等有关。降低病耻感水平对促进患者的康复有重要的意义,但目前干预性研究较少。建议以后的研究着重探索有效降低结核病患者病耻感水平的干预措施。     

社区老年慢性疼痛患者自我效能状况及影响因素

目的了解社区老年慢性疼痛患者自我效能状况及其影响因素。方法采用一般人口学资料调查表,汉化版慢性疼痛自我效能感量表,简明疼痛量表,激惹、抑郁和焦虑自评量表,医学应对问卷,对192例老年慢性疼痛患者进行调查分析。结果老年慢性疼痛患者自我效能得分(75.56±18.33)分,其中疼痛管理自我效能感(16.16±4.63)分,躯体功能自我效能感(32.45±8.60)分,症状应对自我效能感(27.21±8.37)分;影响自我效能感的主要因素是上1 w疼痛最痛程度得分、屈服、当前疼痛程度得分、抑郁、年龄和家庭经济状况,可解释35.6%的变异量。结论社区老年慢性疼痛患者自我效能水平不容乐观,主要受上1 w疼痛最痛程度得分、屈服的应对方式、当前疼痛程度得分、抑郁、年龄和家庭经济状况等因素的影响。     

自我效能对某医院胃癌化疗患者健康素养与生活质量间的中介效应及调节效应

背景生活质量和健康素养是影响胃癌(gastric cancer,GC)患者生活质量的主要因素之一.本研究以GC患者为研究对象,研究自我效能对健康素养及生活质量是否有中介效应和调节效应.目的探讨自我效能在GC化疗患者健康素养与生活质量间的中介效应及调节效应.方法选择2018-01/2019-11在浙江省义乌市中心医院住院的136例GC化疗患者为研究对象,采用一般自我效能感量表中文版,慢性病患者健康素养量表及生活质量指数进行问卷调查,并统计分析.结果患者自我效能得分为22.95分±4.65分,健康素养得分为85.94分±7.56分,生活质量得分为4.84分±0.52分.通过Pearson相关分析显示,GC化疗患者的自我效能与健康素养和生活质量均呈正相关(P<0.05).通过分层回归法分析中介效应,建立3个回归方程.结果表明,在第1步、第2步中检验生活质量和健康素养以及自我效能和健康素养均有统计学意义(P<0.05);在第3步时将自我效能引入,健康素养对生活质量的影响减少(P<0.05),由此表明自我效能在健康素养和生活质量间有部分中介作用.通过多元回归进行调节效应分析,将健康素养及自我效能进行中心化,生成"健康素养×自我效能"的交互作用项,以生活质量为因变量,分别以健康素养,自我效能及交互作用项为自变量进行回归分析.结果表明,"健康素养×自我效能"的回归系数有统计学意义(β’=0.018,t=2.725;P<0.01),且调节效应显著(△R^2=0.018,P<0.01).结论自我效能在GC化疗患者健康素养与生活质量间起中介效应及调节效应.     

Overcoming the influence of chronic pain on older patients' difficulty with recommended self-management activities

PURPOSE: Many older patients with common chronic conditions also experience chronic pain. We examined how chronic pain affects patients' difficulty with recommended self-management activities and the potential intervening role of self-efficacy (the level of confidence in one's own ability to perform a specific task). DESIGN AND METHODS: We obtained data from a cross-sectional nationwide survey of older patients, primarily older men, with chronic health conditions (N = 543). We defined chronic pain as pain present most of the time for 6 months or more during the past year. We assessed ability to follow self-management recommendations by asking respondents to rate their level of difficulty in performing three commonly recommended activities as suggested by their doctor. RESULTS: More than 60% of survey respondents reported chronic pain. Chronic pain was significantly associated with difficulty exercising regularly (odds ratio [OR] = 1.57, 95% confidence interval [CI] = 1.04-2.37) and taking prescribed medications (OR = 3.08, 95% CI = 1.10-8.59) but not with following a recommended eating plan (OR = 1.16, 95% CI = 0.76-1.76). However, when we took self-efficacy into account, chronic pain was no longer significantly associated with either exercise or taking medications. IMPLICATIONS: Chronic pain is a prevalent condition among older patients and is associated with greater reported difficulty performing certain essential self-management activities. Self-efficacy, however, plays an important intervening role. Specifically, higher self-efficacy negated or reduced the association between chronic pain and reported difficulty exercising and taking medications. Promoting self-efficacy among older adults with multiple chronic health problems is a promising strategy to improve their ability to follow self-management recommendations.     

Validation of a Swedish version of the Arthritis Self-efficacy Scale.

The purpose of this study was to test the validity of a Swedish Version of the Arthritis Self-efficacy Scale on two groups of patients: 25 patients with chronic pain and 24 rheumatology patients. Scores on the three subscales of the self-efficacy instrument--for controlling pain, for controlling function of daily living activities, and for controlling other symptoms--were correlated with indicators of present pain status and scores on the Multidimensional Health Locus of Control Scales. All correlations were in the direction predicted by self-efficacy theory, providing evidence for the construct validity of the scale. In addition the two patient groups differed significantly on the three subscales indicating evidence for the discriminant validity of the instrument.     

The impact of improved self-efficacy on HIV viral load and distress in culturally diverse women living with AIDS: the SMART/EST Women's Project

The purpose of the present study was to determine whether changes in self-efficacy over time would be related to changes in disease progression markers (CD4, viral load) in a sample of women with AIDS. A self-efficacy measure was developed and two sub-scales emerged via factor analysis of 391 HIV-positive women: AIDS Self-efficacy and Cognitive Behavioral Skills Self-efficacy. Subsequently, the sub-scales and an additional adherence self-efficacy item were given to 56 HIV-positive women who were measured at two time points three months apart. Half of these women were randomly assigned to a CB intervention and half to a low intensity comparison condition. Increases in AIDS Self-efficacy over the three-month period were significantly related to increases in CD4 and decreases in viral load. Similarly, increases in Cognitive Behavioral Skills Self-efficacy were significantly related to decreases in distress over time. Findings were maintained within the intervention group alone. Interestingly, increases in cognitive behavioral skills self-efficacy and increases in the self-efficacy adherence item were also significantly related to decreases in viral load. Implications of the findings and suggestions for future research are discussed.     

Initial Development of Scales to Assess Self-Efficacy for Disclosing HIV Status and Negotiating Safer Sex in HIV-Positive Persons

Two studies were conducted to develop scales for assessing self-efficacy to disclose HIV status to sex partners and negotiate safer sex practices among people living with HIV/AIDS. Elicitation research was used to derive 4 sets of scenarios with graduated situational demands that serve as stimulus materials in assessing self-efficacy. Two studies demonstrated that the self-efficacy scales for effective disclosure and negotiating safer sex practices were internally consistent, time stable over 1 month, and demonstrated evidence for validity. Self-efficacy scales also demonstrated evidence of criterion-related, convergent, and divergent validity. Reliable and valid instruments for assessing self-efficacy to make effective HIV status disclosure decisions and practice safer sex were therefore developed and these scales can be used in research to explain, predict, and enhance self-efficacy for these important behaviors.     

Simple,illustrated medicines information improves ARV knowledge and patient self-efficacy in limited literacy South African HIV patients

Few studies have investigated antiretroviral (ARV) knowledge and self-efficacy in limited literacy patients. Using a randomized controlled study design, we investigated the influence of a simple pre-tested patient information leaflet (PIL) containing both text and illustrations on HIV- and ARV-related knowledge and on self-efficacy over six months in a limited literacy African population. The recruited patients were randomly allocated to either control (standard care) or intervention group (standard care plus illustrated PIL). HIV and medicines-related knowledge was evaluated with a 22-question test at baseline, one, three, and six months. Self-efficacy was assessed using a modified version of the HIV Treatment Adherence Self-Efficacy Scale. Two-thirds of the patients were female, mean age was 39.0 ± 9.6 years and mean education was 7.3 ± 2.8 years. Patients who received the PIL showed a significant knowledge increase over the six-month period (62.0–94.4%), with improvement at each subsequent interview whereas the control group showed no improvement. At baseline, side effect knowledge was the lowest (50–56%) but increased in the intervention group to 92%. Similarly, other medicine-related knowledge at baseline (57–67%) improved significantly (93%) and was sustained over six months. Cohen's d values post-baseline ranged between 1.36 and 2.18, indicating a large intervention effect. Self-efficacy improved significantly over six months in intervention but not control patients. At baseline, patients with ≤3 years of education had lower knowledge and self-efficacy but this was not observed post-intervention, which we attribute to the PIL mitigating the effect of limited education. Knowledge and self-efficacy were significantly correlated in the intervention group. In conclusion, a low-cost intervention of a well-designed, pre-tested, simple, illustrated PIL significantly increased both ARV knowledge and self-efficacy in HIV patients with limited education.     

The Jack Donovan Memorial Lecturers

The perceived ability to engage in situation-specific behaviors (self-efficacy) to overcome nicotine dependence and alcohol abuse has been shown to correlate significandy with and be predictive of the actual ability to engage in such behaviors. Self-efficacy is also related to subsequent behavior change during treatment and maintenance of this change after treatment termination. In this study, part of a national outcome study, the relationship between self-efficacy and drug use was investigated in a subsample of regular cocaine users (n = 294) who completed at least three months of treatment in community-based outpatient treatment programs. Frequency of cocaine and other drug use was reported for the period of 1 year before treatment and at 1 month and 3 months in treatment. Self-efficacy regarding resisting drug use was measured at 1 and 3 months in treatment. Self-efficacy at 1 month was correlated with cocaine use at 1 month and self-efficacy contributed to the prediction of self-reported drug use at 1 month over and above pretreatment and demographic variables. Similarly, self-efficacy at 3 months was correlated with cocaine use at 3 months and contributed to the prediction of self-reported drug use at 3 months. These outcomes were obtained even though over 75% of subjects reported no drug use during treatment. The results supported previous findings suggesting that increased self-efficacy regarding resisting drug use is associated with lower rates of drug use during treatment, and that self-efficacy enhancement may be an important intervention in the treatment of cocaine use.     

Self-efficacy and the progression of functional limitations and self-reported disability in older adults with knee pain

OBJECTIVES: The prospective relationships between self-efficacy beliefs, in conjunction with measures of knee pain and knee strength, and subsequent decline in both physical performance and self-reported disability among older adults with knee pain were examined. METHODS: In this prospective epidemiological trial, 480 men and women aged 65 years and older who had knee pain on most days of the week and difficulty with daily activity were followed for 30 months. RESULTS: There was a significant interaction of baseline self-efficacy with baseline knee strength in predicting both self-reported disability and stair climb performance. Participants who had low self-efficacy and low strength at baseline had the largest 30-month decline in these outcomes. DISCUSSION: These data underscore the important role that self-efficacy beliefs play in understanding functional decline with chronic disease and aging. Self-efficacy beliefs appear to be most important to functional decline in older adults when they are challenged by muscular weakness in the lower extremities.     

Patientenschulung in der Rheumatologie – eine Übersicht

Patient education is a medical intervention for patients with chronic diseases to increase knowledge of their disease, self-efficacy, self-management and consumer behaviour. The goal is to improve their disease outcome, social participation and quality of life. This article reviews concepts, modalities and knowledge on effectiveness of patient education. The results of different studies in different rheumatic diseases on efficacy will be summarized including a small number of cost-benefit analyses. Most studies report on significant and relevant improvements of knowledge, self-efficacy and health status. With respect to disease specific outcomes low to moderate effect sizes with a short duration have been observed. Especially good results have been reported when physical training or other methods of rehabilitation were included. There are marked improvements in consumer behaviour of health measures and sickness leave. A better understanding of information needs and baseline characteristics of patients is necessary to develop more appropriate educational interventions focussed on relevant outcomes that can be improved by educational measures.