The effect of self-efficacy expectations in the adherence to a gluten free diet in celiac disease

Abstract

Objective: To analyse the effect of general and specific self-efficacy on the adherence to a gluten free diet (GFD) in patients with celiac disease along with the effect of other relevant variables.

Design: 271 patients with celiac disease participated in this transversal descriptive study and completed a series of questionnaires regarding adherence (CDAT), general self-efficacy (GSES) and specific self-efficacy (Celiac-SE) and quality of life (CD-Qol), among others.

Main Outcome Measures: Dependent variable was adherence to the Gluten Free Diet (GFD). Main independent variables were general self-efficacy, specific self-efficacy and quality of life. Model tests were conducted using regression analysis.

Results: 71.9% of patients show an excellent or good adherence to the diet. Higher levels of adherence are positively associated to a high expectancy of specific self-efficacy, to the perceived adoption of recommended behaviours, risk perception and better quality of life (these variables accounted for 36.4% of the variance in the adherence to a GFD, p < .001).

Conclusions: Specific self-efficacy rather than general has a predictive value in adherence to a GFD. Therefore, we need to develop and transculturally adapt new instruments to assess specific self-efficacy. Celiac-SE has proved to be a useful scale for this objective.

Keywords:

• celiac disease
• self-efficacy
• adherence to GFD
• perceived life quality

Acknowledgments

The authors wish to thank the Aragon Celiac Association and other associations of the Spanish Federation of Celiac Associations and to RediAPP Primary Care Prevention and Promotion Network.

Disclosure statement

The authors declare no conflict of interest.

Funding

This study has been funded by project PI16/00570 (Instituto de Salud CarlosIII) and by Fondo Europeo de Desarrollo Regional (FEDER) funds: “Unamanera de hacer Europa”.