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Sabrina M. Neeley, PhD, MPH Assistant Professor Dept. of Community Health

Understanding the Relationship Between Self-Efficacy, Locus of Control, and Self-Management Behaviors in Adult Patients with Ehlers- Danlos Syndrome. Sabrina M. Neeley, PhD, MPH Assistant Professor Dept. of Community Health. Objectives.

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Sabrina M. Neeley, PhD, MPH Assistant Professor Dept. of Community Health

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  1. Understanding the Relationship Between Self-Efficacy, Locus of Control, and Self-Management Behaviors in Adult Patients with Ehlers-Danlos Syndrome Sabrina M. Neeley, PhD, MPH Assistant Professor Dept. of Community Health

  2. Objectives By the end of this session, the learner will be able to: • Explain the meaning of self-management as it relates to chronic health conditions • Explain self-efficacy and its role in the self-management of chronic health conditions • Explain locus of control and how it affects self-management of chronic health conditions • Explain the relationships between self-efficacy, locus of control, and self-management in a sample of adults with EDS

  3. Self-Management Activities people undertake to create order and control as they incorporate a chronic health condition into their daily lives and seek the best possible quality of life • Put together healthcare team • Problem solving • Communicating with healthcare providers • Setting goals • Diet, exercise, preventive care, stress reduction, rest • Mental health

  4. Self-Efficacy The degree to which an individual has confidence in her or his ability to do what needs to be done in order to achieve desired outcomes. • Decreasing and managing pain • Keeping pain from interfering with life • Regulating activity • Keeping fatigue from interfering with life • Helping self feel better • Dealing with frustration

  5. Locus of Control To who/what individuals attribute the status of their condition (positive & negative) • Internal • Chance • Doctors • Others

  6. This Study • Survey of adult EDS patient attendees at 2010 EDNF conference, plus online survey • n=151 • Scientifically recognized, validated, condition-modified scales for self-efficacy (Lorig, et al.) and locus of control (MHLC – Wallston, et al.) • Self-management behaviors derived from discussions with physicians and Stanford University Chronic Disease Self-Management program

  7. Self-Efficacy • 8-questions, 10-pt scale (Certainty) • High score = high self-efficacy • Mean=38; Median=38.5; Mode=40; sd=13.7 • ½ of questions had mean scores < 5, none > 6 • Keep EDS pain from interfering with sleep • Regulate activity to avoid aggravating EDS • Keep EDS pain from interfering with activities** • Keep fatigue from interfering with activities**

  8. Locus of Control • 18 questions, 6-pt scale (Agreement) • 4 subscales • High score = high locus of control • Internal locus of control highest • All scores at approximate scale midpoint

  9. Self-Management • 19 questions, 5-pt scale (Likelihood) • High score = high self-management • Mean=80.35; Median=83; Mode=85; sd=10.6 • Generally, very high scores

  10. Relationships (SE-SM) • SE regulate activity to avoid aggravating EDS • SM develop/implement exercise plan • SM take care of myself mentally & physically • SM accept responsibility to manage problems • SM speak up for myself about treatment/care • SE keep fatigue from interfering with activities • SM develop/implement exercise plan • SM take care of myself mentally & physically

  11. Relationships (SE-SM) • SE keep pain from interfering/decrease pain • SM develop/implement exercise plan • SM take care of myself mentally & physically • SM accept responsibility to manage problems • SM find ways to reduce stress • SE help self feel better/deal with frustrations • SM develop/implement exercise plan • SM take care of myself mentally & physically • SM develop/maintain support systems • SM search/gather information about EDS • SM accept responsibility to manage problems

  12. Conclusions • Self-efficacy generally low • Pain • Fatigue • Interfering with sleep and life • Self-management key behaviors • Exercise plan • Physical & mental care • Accept responsibility for problem-solving Self-efficacy enhanced with successful goal setting and achievement

  13. References Bandura A (1997). Self-efficacy: The Exercise of Control. New York, NY: Freeman. Bodenheimer T, Lorig K, Holman H, Grumbach K (2002). Patient self-management of chronic disease in primary care. JAMA 288: 2469-2475. Farrell K, Wicks MN, Martin JC (2004). Chronic disease self-management improved with enhanced self-efficacy. Clinical Nursing Research 13: 289-308. Kralik D, Koch T, Price K, Howard N (2004). Chronic disease self-management: Taking action to create order. Journal of Clinical Nursing 13; 259-267. Lorig K, Holman H, Sobel D, Laurent D, Gonzalez V, Minor M (2000). Living a Healthy Life with Chronic Conditions. Palo Alto, CA: Bull Publications. Norman P, Bennett P, Smith C, Murphy S (1998). Health locus of control and health behavior. Journal of Health Psychology 3: 171-180. Wallston KA, Stein MJ, Smith KA (1994). Form C of the MHLC scales: A condition-specific measure of locus of control. Journal of Personality Assessment 63; 534-553.

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