Background Systemic lupus erythematosus (SLE) patients have a worse health-related quality of life (HRQoL) than the general population. This seems to be related to patients characteristics like age, poverty, behavioral issues rather than to disease activity or damage. Self-efficacy is defined as individual’s confidence on performing a task and could impact on patient-reported outcomes.
Objectives To determine the possible predictive value of self-efficacy on HRQoL in SLE patients.
Methods SLE patients from a single-center prevalent cohort were included. Self-efficacy was ascertained with six instruments of the Patient-Reported Outcomes Measurement Information System (PROMIS) Self-efficacy for Managing Chronic Conditions. Instruments included were general self-efficacy, and self-efficacy for managing emotions, managing symptoms, managing daily activities, managing social interactions and managing medications and treatments. For PROMIS instruments, a score of 50 is the average for a clinical population (people with a chronic condition), a higher score indicates that the respondent has greater self-efficacy. HRQoL was ascertained with the physical and mental component summary (PCS and MCS) measures of the Short-Form 36 (SF-36). Generalized estimating equations were performed, using as outcome the PCS or MCS in the subsequent visit, and the self-efficacy instrument in the previous visit; multivariable models were adjusted for possible confounders (age at diagnosis, gender, socioeconomic status, SLEDAI-2K, SLICC/ACR damage index, disease duration at baseline, prednisone daily dose, antimalarial and immunosuppressive drugs use and PCS or MCS in the previous visit). All the confounders were measured in the same visit than the self-efficacy instrument.
Results Two-hundred and nine patients for a total of 564 visits were included; 194 (92.8%) patients were women, mean age at diagnosis was 36.4 (14.0) years and disease duration at baseline was 6.5 (6.0) years. At baseline, PCS was 55.0 (22.3) and MCS was 53.9 (20.4). At baseline, mean general self-efficacy was 47.2 (10.4), self-efficacy for managing emotions was 44.6 (8.0), for managing symptoms was 47.7 (8.2), for managing daily activities was 45.5 (7.5) for managing social interactions was 42.9 (7.9) and for managing medications and treatment was 43.9 (7.0). In the multivariable models a better PCS was predicted by a better general self-efficacy, and self-efficacy for managing symptoms, managing social interactions and managing medications and treatments and a better MCS was predicted by a better self-efficacy for managing symptoms, managing daily activities, managing social interactions and managing medications and treatments. These data are depicted in Table 1.
Conclusion A better self-efficacy is predictive of a subsequent better HRQoL, even after adjustment for possible confounders. These results should encourage clinicians to develop strategies to improve self-efficacy in SLE patients.
Disclosure of Interests Manuel F. Ugarte-Gil Grant/research support from: Janssen, Pfizer, Rocío Violeta Gamboa Cárdenas Grant/research support from: Pfizer, Cristina Reategui Sokolova Grant/research support from: Janssen, Victor Pimentel-Quiroz Grant/research support from: Janssen, Mariela Medina Chinchon: None declared, Claudia Elera-Fitzcarrald: None declared, Zoila Rodriguez Bellido: None declared, Cesar Pastor Asurza: None declared, Risto Perich Campos: None declared, Graciela S Alarcon: None declared
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