ORIGINAL PAPER
Psychosocial and behavioral correlates
of self-efficacy in treatment adherence
in older patients with comorbid hypertension
and type 2 diabetes
1
Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
2
Department of Psychology, University of Milano-Bicocca, Milan, Italy
3
Department of Cardiac Respiratory Rehabilitation of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
4
Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
5
IV Military Clinical Hospital of Wroclaw, Wroclaw, Poland
6
Respiratory Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
7
Cardiological Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
8
Neuromotor Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
9
Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
Submission date: 2022-06-01
Final revision date: 2023-01-05
Acceptance date: 2023-01-13
Online publication date: 2023-03-09
Publication date: 2023-08-22
Corresponding author
Health Psychology Report 2023;11(3):188–199
KEYWORDS
TOPICS
psychological aspects of illnesshealth attitudes and behaviorincluding prevention and promotionlifespan approaches to health, including those related to older adults
ABSTRACT
Background:
Adhering to clinical prescriptions is known to protect against the effects of uncontrolled hypertension and of acute and chronic cardiovascular diseases, including diabetes. Contextually, positive associations between self-care behaviors and psychological constructs, such as self-efficacy, are widely acknowledged in the literature. However, still little is known about the psychological factors underlying the patient’s self-efficacy. This study aimed to investigate the psychosocial and behavioral correlates of self-efficacy related to treatment adherence in older patients with comorbid hypertension and type 2 diabetes mellitus.
Participants and procedure:
Italian and Polish patients (≥ 65 years; N = 180) consecutively responded to self-report questionnaires measuring psycho-social (i.e., beliefs about medicines, perceived physician’s communication effectiveness, medication-specific social sup-port, self-efficacy) and behavioral factors (i.e., pharmacological adherence, medications refill adherence, intentional non-adherence) related to treatment adherence. Between-group comparisons and regression analyses were performed.
Results:
Fisher’s least significant difference (LSD) test showed significant differences between the Italian and Polish groups in all questionnaires (p < .01) with the Italian patients reporting more satisfactory scores. Younger age (β = .08, p = .045), female gender (β = 1.03, p = .042), higher medication refills adherence (β = –.07, p = .024), lower intentional non-adherence (β = –.03, p = .009), positive beliefs about medications (β = .13, p < .001), better quality of communication with the physician (β = .09, p < .001), and stronger perceived medication-specific social support (β = .06, p = .001) were significantly associat-ed with self-efficacy related to treatment adherence.
Conclusions:
Future research and interventions should leverage psychosocial and behavioral factors to address self-efficacy contributing to enhancing adherence to clinical prescriptions.
Adhering to clinical prescriptions is known to protect against the effects of uncontrolled hypertension and of acute and chronic cardiovascular diseases, including diabetes. Contextually, positive associations between self-care behaviors and psychological constructs, such as self-efficacy, are widely acknowledged in the literature. However, still little is known about the psychological factors underlying the patient’s self-efficacy. This study aimed to investigate the psychosocial and behavioral correlates of self-efficacy related to treatment adherence in older patients with comorbid hypertension and type 2 diabetes mellitus.
Participants and procedure:
Italian and Polish patients (≥ 65 years; N = 180) consecutively responded to self-report questionnaires measuring psycho-social (i.e., beliefs about medicines, perceived physician’s communication effectiveness, medication-specific social sup-port, self-efficacy) and behavioral factors (i.e., pharmacological adherence, medications refill adherence, intentional non-adherence) related to treatment adherence. Between-group comparisons and regression analyses were performed.
Results:
Fisher’s least significant difference (LSD) test showed significant differences between the Italian and Polish groups in all questionnaires (p < .01) with the Italian patients reporting more satisfactory scores. Younger age (β = .08, p = .045), female gender (β = 1.03, p = .042), higher medication refills adherence (β = –.07, p = .024), lower intentional non-adherence (β = –.03, p = .009), positive beliefs about medications (β = .13, p < .001), better quality of communication with the physician (β = .09, p < .001), and stronger perceived medication-specific social support (β = .06, p = .001) were significantly associat-ed with self-efficacy related to treatment adherence.
Conclusions:
Future research and interventions should leverage psychosocial and behavioral factors to address self-efficacy contributing to enhancing adherence to clinical prescriptions.
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