Factors influencing self-care among patients with primary hypertension: path analysis of mediating roles of self-efficacy and depressive symptoms

Author:

Chen Ting-Yu1,Kao Chi-Wen2ORCID,Cheng Shu-Meng3ORCID,Liu Chieh-Yu4ORCID

Affiliation:

1. Department of Nursing, Chang Gung University of Science and Technology , Rm. A611, No. 2, Sec. W., Jiapu Rd., Puzi City, Chiayi County 613016 , Taiwan

2. National Defense Medical Center, School of Nursing , No.161, Sec. 6, Minquan E. Rd, Neihu Dist., Taipei 11490 , Taiwan

3. Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center , No. 325, Sec.2, Chenggong Rd., Neihu District, Taipei City 114202 , Taiwan

4. Department of Health Care Management, National Taipei University of Nursing and Health Sciences , No. 365, Ming-te Road, Peitou District, Taipei City 112303 , Taiwan

Abstract

Abstract Aims Blood pressure control requires medication adherence and lifestyle modifications. Social cognitive theory suggests social support, psychological adaptation, and self-efficacy can reinforce lifestyle modifications. This study investigated if self-efficacy was a mediator between self-rated health status (SRHS), social support, depressive symptoms, anxiety, and self-care among patients with hypertension. Method and results This cross-sectional study recruited patients with primary hypertension by convenience sampling (N = 318) from an outpatient cardiology clinic. Data included participant characteristics and self-report scales for social support, SRHS, anxiety, depressive symptoms, Self-efficacy and self-care diet quality and weight management. We used path analysis to test the hypothesized model. The mean age of participants was 63.91 ± 11.80 years. Mean scale scores for social support and depressive symptoms were 54.23 ± 13.26 and 6.14 ± 3.14, respectively; SRHS was 66.91 ± 13.80, self-efficacy was 34.31 ± 11.62, self-care for diet quality and weight management were 36.50 ± 13.19 and 27.38 ± 8.64, respectively. Bootstrapping demonstrated self-efficacy was the mediator between social support and self-care for diet quality and weight management; depressive symptoms mediated the relationship between social support and self-efficacy. In addition, the variable of depressive symptoms was also a mediator between SRHS and self-efficacy. The final model showed SRHS, social support, depressive symptoms, and self-efficacy explained 28% of self-care. Conclusion Our findings suggest developing theory-based interventions for patients with hypertension that provide education and/or psychological support for increasing patients’ self-efficacy and reducing depressive symptoms simultaneously to facilitate their long-term self-care behaviours.

Funder

Ministry of National Defense

Publisher

Oxford University Press (OUP)

Subject

Advanced and Specialized Nursing,Medical–Surgical Nursing,Cardiology and Cardiovascular Medicine

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