Trajectories of self-efficacy in persons with chronic illness: An explorative longitudinal study

Abstract

Background: Self-efficacy is important for changing health behaviour in persons with chronic illness. Longer term trajectories have not been previously explored.

Objective: This study’s objective was to explore the trajectories of self-efficacy in two different groups with chronic illnesses attending a patient education course.

Design: The study design was a longitudinal, comparative cohort study with five time points during a one-year follow-up, using repeated measures analysis of variance.

Setting and participants: Persons with morbid obesity (n = 55) and persons with chronic obstructive pulmonary disease (COPD; n = 56) were recruited at the start of patient education courses in Norway and followed-up four times the following year.

Main outcome measure: The General Self-Efficacy Scale was the main outcome.

Results: Obese persons showed a linear pattern of increasing self-efficacy during the follow-up period, whereas persons with COPD had an initial increase followed by a decrease in self-efficacy. Having paid work was associated with a more positive self-efficacy trajectory.

Conclusion: The results provide support for the currently employed patient education course for morbidly obese persons. In contrast, persons with COPD may need more extensive and/or more frequent support in order to increase and maintain self-efficacy across time.

Keywords:

• self-efficacy
• illness perceptions
• morbid obesity
• chronic obstructive pulmonary disease
• longitudinal study

Acknowledgements

The study was funded by the Norwegian Centre for Patient Education, Research and Service Development, Oslo, Norway. The funding source had no further involvement in any part of the research process. The contributions from the following Norwegian institutions are acknowledged: The Patient Education Centers at Oslo University Hospital – Aker, Oslo; Deacon’s Hospital, Oslo; Lovisenberg Diakonale Hospital, Oslo; Asker and Bærum Hospital, Sandvika; Østfold Hospital, Sarpsborg; and Stavanger University Hospital, Stavanger. In addition, we acknowledge the contributions of the Pulmonary Rehabilitation Clinics at Oslo University Hospital – Ullevål, Oslo; Krokeide Center, Nærland; and Glittreklinikken, Nittedal.