D 06 The relationship of co-morbidities and self-efficacy in regimen management

Monday, 18 November 2013: 10:00 AM-11:15 AM
Description/Overview: Translation of interventions may be influenced by individual or populations characteristics. In our program project grant we are examining factors which will impact the translation of behavioral interventions. One factor is the complexity of care the patient is managing reflected in the number of co-morbidities the patient has. This presentation examines the relationship of co-morbidities and self-efficacy across four populations and the potential mediating relationship of quality of life, depression, and number of medications prescribed. The sample consisted of 462 persons participating in one of four studies examining behavioral interventions to improve adherence or management of medications. The populations consisted of caregivers of adults with cognitive decline (3M), adults with diabetes, hypertension, and hyperlipidemia (HABIT), adults with diabetes and depression (CONCORDANCE), and adults with obesity (SELF). The sample was 70.3% white, 69.2% female, with an average age of 59 years and an average of 15 years of formal education. Data across the studies suggested there was a low but significant negative relationship between the number of co-morbidities and self-efficacy (r=-0.224, p<.001). For the two diabetes studies, quality of life mediated the relationship, (HABIT physical function SF36, EST=-0.076, p<.001 and CONCORDANCE mental health SF36, EST=0.191, p<.010). Depression (BDI) mediated the relationship in HABIT (EST -0.052, p<.019) and number of medications mediated the relationship in CONCORDANCE (EST=-0.100, p<.009). No other mediational effects were found. Efforts to boost self-efficacy are an integral component of many behavioral interventions. Our data suggest that persons with greater numbers of co-morbidities are likely to have lower self-efficacy. The question arises as to whether different self-efficacy enhancing strategies would be more effective for persons with few or many co-morbidities. The finding that quality of life, reflected in SF36 component scores, impacts this relationship among diabetes patients but not among caregivers or otherwise healthy obese needs further investigation.
Learner Objective #1: Examine the overall impact of the number of co-morbidities on self-efficacy in regimen management, and potential mediating factors, across study populations
Learner Objective #2: Examine study and/or population differences in the relationship between co-morbidities and self-efficacy
Moderators:  Carol C Forsyth, RN, MSN, CRNP
Symposium Organizers:  Jacqueline Dunbar-Jacob, PhD, RN, FAAN, School of Nursing, University of Pittsburgh, Pittsburgh, PA
The relationship of co-morbidities and self-efficacy in regimen management

Jacqueline Dunbar-Jacob, PhD, RN, FAAN1
Susan M. Sereika, PhD1
Maura K. McCall, MSN, RN1
Charlotte Brown, PhD2
Lora E. Burke, PhD, MPH, RN, FAAN1
Judith A. Erlen, PhD, RN, FAAN1
Carol Stilley, PhD, RN1
Catherine M. Bender, PhD, RN, FAAN1
Jennifer Lingler, PhD, CRNP1
(1)School of Nursing, University of Pittsburgh, Pittsburgh, PA
(2)School of Medicine: Psychiatry and School of Nursing, University of Pittsburgh, Pittsburgh, PA



Factors Associated with Patients' Perceived Ability to Manage Multiple Chronic Illnesses

Charlotte Brown, PhD1
John Kasckow, MD, PhD2
Janet Ingram, BA3
Maura K. McCall, MSN, RN4
Jacqueline Dunbar-Jacob, PhD, RN, FAAN4
Susan M. Sereika, PhD4
(1)School of Medicine: Psychiatry and School of Nursing, University of Pittsburgh, Pittsburgh, PA
(2)School of Medicine, Psychiatry, University of Pittsburgh, Pittsburgh, PA
(3)Health and Behavior Studies Program, University of Pittsburgh, Pittsburgh, PA
(4)School of Nursing, University of Pittsburgh, Pittsburgh, PA



Associations among Co-morbid Conditions, Health-Related Quality of Life and Self-Efficacy in Adults Seeking Weight Loss Treatment

Lora E. Burke, PhD, MPH, RN, FAAN1
Mindi A. Styn, PhD1
Lei Ye, BMed2
Yaguang Zheng, BSN1
Meghan Mattos, BSN1
Susan M. Sereika, PhD1
(1)School of Nursing, University of Pittsburgh, Pittsburgh, PA
(2)School of Nursing; Biostatistics, University of Pittsburgh, Pittsburgh, PA



Relationships among Co-morbidities, Self-efficacy, and Quality of Life in Caregivers of Community Dwelling Patients with Memory Loss

Judith A. Erlen, PhD, RN, FAAN
Jennifer Lingler, PhD, CRNP
Lisa K. Tamres, MS
Susan M. Sereika, PhD
School of Nursing, University of Pittsburgh, Pittsburgh, PA



Patient Factors and Quality of Life

Carol Stilley, PhD, RN
Catherine M. Bender, PhD, RN, FAAN
William Flynn, MA
School of Nursing, University of Pittsburgh, Pittsburgh, PA