Exploring the Contribution of General Self-Efficacy to the Use of Self-Care Symptom Management Strategies by People Living with HIV Infection
Exploring the Contribution of General Self-Efficacy to the Use of Self-Care Symptom Management Strategies by People Living with HIV Infection
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DOI：
10.1089/apc.2011.0404
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发表时间：
2012-06-01
影响因子：
4.9
通讯作者：
Holzemer, William L.
中科院分区：
文献类型：
--
作者：
Corless, Inge B.;Wantland, Dean;Holzemer, William L.
一般自我效能（GSE），一个人能够成功地执行一项行为的期望，可以区分那些能够成功地利用自我护理症状管理策略（SCSMS）。这项对国际12个研究中心纵向随机对照试验（RCT）（n = 775）的亚组分析（n = 569）研究了GSE作为决定症状负担、SCSMS、与提供者的接触以及随时间推移的药物依从性的重要因素，并确定了GSE评分高和低的患者在这些变量方面的差异。采用参数和非参数重复测量检验评估GSE和SCSMS对焦虑、抑郁、腹泻、疲劳、恶心和神经病变的感知有效性。对GSE的症状负担、与提供者的接触和抗逆转录病毒治疗依从性进行了分析。我们的数据表明，随着时间的推移，GSE的艾滋病毒感染者的感知症状负担存在差异。那些具有较高GSE的个体的症状较少，并且这些症状被认为比低GSE组经历的症状不那么强烈。除了低GSE组使用非法物质外，高GSE组与低GSE组使用的SCSMS几乎没有有意义的差异。低GSE组也明显（p= < 0.001）较少与他们的医疗保健提供者接触。鉴于物质使用的差异，感知GSE，以及与医疗保健提供者的参与的重要性，更多地关注那些低GSE的医疗保健提供者的关注的解决方案是必要的。
General self-efficacy (GSE), the expectation that one is able to perform a behavior successfully, may differentiate those who are able to successfully utilize self-care symptom management strategies (SCSMS). This subanalysis (n = 569) of an international 12 site longitudinal randomized controlled trial (RCT) (n = 775), investigated GSE as an important factor determining symptom burden, SCSMS, engagement with the provider, and medication adherence over time, and identified differences in those with high and low GSE ratings concerning these variables. Parametric and nonparametric repeated-measures tests were employed to assess GSE and the perceived effectiveness of SCSMS for anxiety, depression, diarrhea, fatigue, nausea, and neuropathy. Symptom burden, engagement with the provider, and antiretroviral adherence were analyzed with regard to GSE. Our data indicated that there were differences in the perceived symptom burden over time of HIV infected individuals by GSE. Those individuals with higher GSE had fewer symptoms and these symptoms were perceived to be less intense than those experienced by the low GSE group. There were few meaningful differences in the SCSMS used by those with high versus low GSE other than the use of illicit substances in the low GSE group. The low GSE group was also significantly (p= < 0.001) less engaged with their healthcare providers. Given the difference in substance use by perceived GSE, and the importance of engagement with the healthcare provider, more attention to the resolution of the concerns of those with low GSE by healthcare providers is warranted.