Self-efficacy adn adherence to treatment: The mediating effects of social support

Main Article Content

María José Martos-Méndez

Abstract

Treatment adherence is a key health behavior in chronic patients. This study investigates the mediating role of perceived social support in the relationship between perceived self-efficacy and adherence to treatment. The sample is composed of 202 chronic patients living in Spain. Stratified random sampling was used to select participants based on the variables age group and type of disease. As predicted, patient self-efficacy is associated with lower levels of nonadherence as well as greater perceived social support. The results show that self-efficacy has a significant direct effect and an indirect effect (through social support and satisfaction with support) on patient adherence, specifically regarding diet and exercise. This study contributes to understand the processes underlying increased levels of nonadherence to treatment in people with lower self-efficacy and less social support. The results are discussed in terms of their contribution to future intervention programs for improving adherence to treatment in chronic patient groups.

Article Details

How to Cite
Martos-Méndez, M. J. (2015). Self-efficacy adn adherence to treatment: The mediating effects of social support. Journal of Behavior, Health & Social Issues, 7(2), 19–29. https://doi.org/10.5460/jbhsi.v7.2.52889
Author Biography

María José Martos-Méndez, Universidad de Málaga. Departamento de Psicología Social, Trabajo Social, Antropología Social y Estudios de Asia Oriental. Profesora Contratada Doctora.

Nombre: María José Martos-Méndez. Grado: Doctora en Psicología. Adscripción: Universidad de Málaga. Departamento de Psicología Social, Trabajo Social, Antropología Social y Estudios de Asia Oriental. Profesora Contratada Doctora. Línea de investigación: 1. Apoyo social, salud y calidad de vida. 2. Intervención psicosocial en colectivos vulnerables (inmigrantes, pacientes crónicos, cáncer, etc.). Dirección postal: Universidad de Málaga. Facultad de Psicología. Campus de Teatinos s/n. 29071, Málaga.

España. Correo: mjmartos@uma.es

References

Acuña-Gurrola, M.R. & González-Celis-Rangel, A.N. (2010). Autoeficacia y red de apoyo social en adultos mayores. Journal of Behavior, Health and Social Issues, 2, 71-81. doi:10.5460/jbhsi.v2.2.26792

Álvarez, E. & Barra, E. (2010). Autoeficacia, estrés percibido y adherencia terapéutica en pacientes hemodializados. Ciencia y enfermería, 16, 63-72. doi:10.4067/S0717-95532010000300008

Amado, E., Pujol, E., Pacheco, V. & Borras, J.M. (2011). Knowledge and adherence to antihypertensive therapy in primary care: results of a randomized trial. Gaceta Sanitaria, 25, 1, 62-67. doi:10.1016/j.gaceta.2010.09.015

Anderson, E.S., Winett, R.A., Wojcik, J.R. & Williams, D.M. (2010). Social cognitive mediators of change in a group randomized nutrition and physical activity intervention: social support, self-efficacy, outcome expectations and self-regulation in the Guide to Healtt Trial. Journal of Health Psychology, 15, 21-32. doi:10.1177/1359105309342297

Avendaño, M.J. & Barra, E. (2008). Autoeficacia, Apoyo Social y Calidad de Vida en Adolescentes con Enfermedades Crónicas. Terapia psicológica, 26, 165-172.

Bandura, A. (1977). Self-efficacy: toward unifying theory of behavior change. Psychological Review, 84, 191-215. doi:10.1037/0033-295X.84.2.191

Bandura, A. (1994). Self-efficacy. In V.S. Ramachaudran (Ed.), Encyclopedia of human behavior (Vol. 4, pp. 71-81). New York: Academic Press. (Reprinted in H. Friedman [Ed.], Encyclopedia of mental health. San Diego: Academic Press, 1998).

Bandura, A. (1999). A social cognitive theory of personality. In L. Pervin & O. John (Eds.), Handbook of personality (2nd ed., pp. 154– 196). NewYork: Guilford Publications.

Bandura, A. (2005). The evolution of social cognitive theory. In K.G. Smith & M.A. Hitt (Eds.) Great Minds in Management. (p.1) Oxford: Oxford University Press.

Bandura, A., Pastorelli, C., Barbaranelli, C., & Caprara, G.V. (1999). Self-efficacy pathways to childhood depression. Journal of Personality and Social Psychology, 76, 258-269. doi:10.1037/0022-3514.76.2.258

Baron, R.M., & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173-1182. doi:10.1037/0022-3514.51.6.1173

Becker, M.H. & Mainman, L.A. (1975). Sociobehavioral determinats of compliance with health and medical care recommendations. Medical Care, 13, 10-14. doi:10.1097/00005650-197501000-00002

Bosworth, H.B., Oddone, E.Z. & Weinberger, M. (2006). Patient treatment adherence. Concepts, interventions and measurement. New Jersey: Lawrence Erlbaum Associates.

Brassington, G.S., Atienza, A.A., Perczek, R.E., DiLorenzo, T.M. & King, A.C. (2002). Intervention-related cognitive versus social mediators of exercise adherence in the elderly. American Journal of Preventive Medicine, 23, 80-86. doi:10.1016/S0749-3797(02)00477-4

Chen, A.M., Yehle, K.S., Albert, N.M., Ferraro, K.F., Mason, H.L., Murawski, M.M. et al. (2013). Relationships between health literacy and heart failure knowledge, self-efficacy, and self-care adherence. Research in Social and Administrative Pharmacy, 13. doi:10.1016/j.sapharm.2013.07.001

Cohen, S., Gottlieb, B.H. & Underwood, L.G. (2000). Social relationships and health. In S. Cohen, L.G. Underwood & B.H. Gottlieb (Eds.), Social support measurement and intervention. A guide for health and social scientists. Oxford: Oxford University Press.

Connolly, F.R., Aitken, L.M. & Tower, M. (2013). An integrative review of self-efficacy and patient recovery post-acute injury. Journal of Advanced Nursing, (Review Paper), 1-15. doi:10.1111/jan.12237

Epstein, L.H. & Cluss, P.A. (1982). A behavioral medicine perspective on adherence to long-term medical regimens. Journal of Consulting and Clinical Psychology, 50, 950-971. doi:10.1037/0022-006X.50.6.950

Fernández, A.M., Bujalance, M.J., Leiva, F., Martos, F., García., A.J. & Sánchez, F. (2001). Salud autopercibida, apoyo social y familiar de los pacientes con enfermedad pulmonar obstructiva crónica. MEDIFAM, 11, 530-539. doi:10.4321/s1131-57682001000900003

Fernández, S., López, M. L., Comas, A., García, A. & Cueto, A. (2003). Categorización de factores psicosociales asociados al cumplimiento farmacológico antihipertensivo. Psicothema, 15, 82-87.

Ferrer, V.A. (1995). ”Adherencia a” o “Cumplimiento de” prescripciones terapéuticas y de salud: Concepto y factores psicosociales implicados. Revista de Psicología de la Salud, 7, 35-61.

Froján, M.X. & Rubio, R. (2005). Discrimant analysis of treatment adherence in insulindependent diabetes mellitus. Psychology in Spain, 9, 41-48

Granados, G., Roales-Nieto, J.G., Moreno, E. & Ybarra, J.L. (2007). Creencias en síntomas y adherencia al tratamiento farmacológico en pacientes con hipertensión. International Journal of Clinical and Health Psychology, 7, 697-707.

Gross, R., Tabenkin, H., Porath, A., Heymann, A., Greenstein, M., Porter, B. et al. (2003). The relationship between primary care physicians’ adherence to guidelines for the treatment of diabetes and patient satisfaction: findings from a pilot study. Family Practice, 20, 563-569. doi:10.1093/fampra/cmg512

Hayes, R.B. (2002). Helping patients follow prescribed treatment: Clinical applications. JAMA, 288, 2880-2883. doi:10.1001/jama.288.22.2880

Haynes, R.B., Sackett, D.L., Taylor, D.W. & Snow, J.C. (1979). Appendix 1: Annotated and indexed bibliography on compliance with therapeutic and preventative regimens. In R.B. Haynes, D.W. Taylor & D.L. Sackett (Editors). Compliance in Health Care. Baltimore: The Johns Hopkins. University Press.

Hoth, K.F., Christensen, A.J., Ehlers, S.L., Raichle, K.A. & Lawton, W.J. (2007). A longitudinal examination of social support, agreeableness and depressive symptoms in chronic kidney disease. Journal of Behavioral Medicine, 30, 69-76. doi:10.1007/s10865-006-9083-2

Jackson, E.S., Tucker, C.M. & Herman, K.C. (2007). Health value, perceived social support and health self-efficacy as factors in a health-promotion lifestyle. Journal of American College Health, 56, (69-74). doi:10.3200/JACH.56.1.69-74

Kara, B., Caglar, K. & Kilic, S. (2007). Nonadherence with diet and fluid restrictions and perceived social support in patients receiving hemodialysis. Journal of Nursing Scholarship, 39, 243-248. doi:10.1111/j.1547-5069.2007.00175.x.

Kronish, I.M. & Ye, S. (2013). Adherence to cardiovascular medications: Lessons learned and future directions. Progress in Cardiovascular Diseasess, 55, 590-600. doi:10.1016/j.pcad.2013.02.001

Ladero, L., Orejudo, S. & Carrobles, J.A. (2010). Apoyo social y adhesión al tratamiento antirretroviral en pacientes VIH+ en un Programa de mantenimiento con metadona. Un estudio longitudinal. Clínica y Salud, 1, 21-33. doi:10.5093/cl2010v21n1a3

Lewis, M.A., & Rook, K.S. (1999). Social control in personal relationships: Impact on health behaviors and psychological distress. Health Psychology, 18, 63–71. doi:10.1037/0278-6133.18.1.63

Luszczynska, A., Sheng Cao, D., Mallach, N., Prieton, K., Mazurkiewicz, M. & Schwarzer, R. (2010). Intentions, planning and self-efficacy predict physical activity in Chinese and Polish adolescents: two moderated mediation analyses. International Journal of Clinical and Health Psychology, 10, 265-278.

Marín-Reyes, F. & Rodríguez-Morán, M. (2001). Apoyo familiar en el apego al tratamiento de la hipertensión arterial esencial. Salud Pública de México, 43, 336-339. doi:10.1590/S0036-36342001000400010

Martín, L., Bayarre, H., La Rosa, Y., Orbay, M.C., RodrígueZ, J., Vento, F. et al. (2007). Cumplimiento e incumplimiento del tratamiento antihipertensivo desde la perspectiva del paciente. Revista Cubana de Salud Pública, 33, 1-10.

Martín-Aragón, M., Pastor, M.A., Rodríguez-Marín, J., March, M.J., Lledó, A., López-Roig, S. et al. (1999). Percepción de autoeficacia en dolor crónico: Adaptación y validación de la Chronic Pain Self-Efficacy Scale. Revista de Psicología de la Salud, 11, 53-75.

Martos, M.J., Pozo, C. & Alonso, E. (2008). Influencia de las relaciones interpersonales sobre la salud y la conducta de adherencia en una muestra de pacientes crónicos. Boletín de Psicología, 93, 59-77.

Martos, M.J. & Pozo, C. (2011a). Apoyo funcional vs. disfuncional en una muestra de pacientes crónicos. Su incidencia sobre la salud y el cumplimiento terapéutico. Anales de psicología, 27, 47-57.

Martos, M.J. & Pozo, C. (2011b). Adaptación al español de la “Escala de apoyo social percibido específico para la enfermedad” de Revenson et al., 1991. Psicothema, 23, 795-801.

Meichenbaum, D. & Turk, D.C. (1991). Como facilitar el seguimiento de los tratamientos terapéuticos. Guía práctica para los profesionales de la salud. Bilbao: DDB

Molassiotis, A., Nahas-López, V., Chung W.Y.R., Lam S.W.C., Li C.K.P. & Lau T.F.J. (2002). Factors associated with adherence to antiretroviral medication in HIV-infected patients. International Journal of STD & AIDS, 13, 301-310. doi:10.1258/0956462021925117

Raggi, A., Leonardi, M., Mantegazza, R., Casale, S. & Fioravanti, G. (2010). Social support and self-efficacy in patients with Myasthenia Gravis: a common pathway towards positive health outcomes. Neurological Sciences, 31, 231-235. doi:10.1007/s10072-009-0194-8.

Revenson, T.A., Schiaffino, K.M., Majerovitz, S.D. & Gibofsky, A. (1991). Social support as a double-edged sword: the relation of positive and problematic support to depression among rheumatoid arthritis patients. Social Science and Medicine, 33, 807-813. doi:10.1016/0277-9536(91)90385-P

Revicky, D.A., & May, H.J. (1985). Occupational stress, social support, and depression. Health Psychology, 4, 61–77. doi:10.1037/0278-6133.4.1.61

Rodríguez-Marín, J. (2006). Cumplimiento de regímenes terapéuticos y calidad asistencial. Revista de calidad asistencial, 21, 255-263. doi:10.1016/S1134-282X(06)70791-6

Roglic, G. & Unwin, N. (2010). Mortality attributable to diabetes: estimates for the year 2010. Diabetes Research and Clinical Practice, 87, 15-19. doi:10.1016/j.diabres.2009.10.006

Rosenstock, I.M. (1974). The Health Belief Model and prevention health behavior. Health Education Monographs, 2, 354-386.

Rosner, F. (2006). Patient noncompliance: causes and solutions. The Mount Sinai Journal of Medicine, 73, 553-559.

Sarafino, E.P. (2006). Health Psychology: biopsychosocial interactions. New York: Wiley.

Serrano-Castro, P.J., Pozo-Muñoz, C., Alonso-Morillejo, E., Martos-Méndez, M.J. & Bretones-Nieto, B. (2011). Factores vinculados a la adhesión al tratamiento en pacientes con epilepsia refractaria y no refractaria. Revista de Neurología, 53, 721-728.

Serdá, B.C., Del Valle, A. & Marcos-Gragera, R. (2012). La Adherencia al Ejercicio Físico en un Grupo con Cáncer de Próstata: un Modelo Integrado para la Mejora de la Calidad de Vida. Psychosocial Intervention, 21, 29-40. doi:10.5093/in2012v21n1a4

Smith, W.C., Anderson, E., Salinas, D., Horvatek, R., & Baker, D.P. (2015). A meta-analysis of education effects on chronic disease: The causal dynamics of the Population Education Transition Curve. Social Science & Medicine, 127, 29-40. doi:10.1016/j.socscimed.2014.10.027

Stretcher, V.J. & Rosenstock, I.M. (1997). The Health Belief Model. In K. Glanz, F.M. Lewis & B.K. Rimer (Eds.), Health behavior and health education: Theory, research and practice. San Francisco: Jossey-Bass.

Turk, D.C. & Meichembaum, D. (1991). Adherence to self-care regimens. The patient’s perspective. In, J.J. Sweet, R.Z. Rozensky & S.M. Tovian, (Eds.) Handbook of clinical psychology in medical settings. Nueva York: Plenum Press. doi:10.1007/978-1-4615-3792-2_15

Uchino, B.N. (2004). Social support and physical health: understanding the health consequences of relationships. Yale University Press, New Haven, CT. doi:10.12987/yale/9780300102185.001.0001

Umberson, D. (1987). Family status and health behaviors: Social control as a dimension of social integration. Journal of Health and Social Behavior, 28, 306–319. doi:10.2307/2136848

Vinaccia, S., Contreras, F., Palacio, C., Marín, A., Tobón, S. & Moreno-San Pedro, E. (2005). Disposiciones fortalecedoras: Personalidad resistente y autoeficacia en pacientes con diagnóstico de artritis reumatoide. Terapia Psicológica, 23, 15-24.

World Health Organization (WHO) (2004). Adherence to long-term therapies: Evidence for action. Geneva: WHO.

Zeber, J.E., Manias, E., Williams, A.F., Hutchins, D., Udezi, W.A., Roberts, C.S. et al. (2013). A Systematic Literature Review of Psychosocial and Behavioral Factors Associated with Initial Medication Adherence: A Report of the ISPOR Medication Adherence & Persistence Special.