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      Psychosocial and behavioral correlates of self-efficacy in treatment adherence in older patients with comorbid hypertension and type 2 diabetes

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          Abstract

          BACKGROUND

          Adhering to clinical prescriptions is known to protect against the effects of uncontrolled hypertension and of acute and chronic cardiovascular diseases, including diabetes. Contextually, positive associations between self-care behaviors and psychological constructs, such as self-efficacy, are widely acknowledged in the literature. However, still little is known about the psychological factors underlying the patient’s self-efficacy. This study aimed to investigate the psychosocial and behavioral correlates of self-efficacy related to treatment adherence in older patients with comorbid hypertension and type 2 diabetes mellitus.

          PARTICIPANTS AND PROCEDURE

          Italian and Polish patients (≥ 65 years; N = 180) consecutively responded to self-report questionnaires measuring psychosocial (i.e., beliefs about medicines, perceived physician’s communication effectiveness, medication-specific social support, self-efficacy) and behavioral factors (i.e., pharmacological adherence, medications refill adherence, intentional non-adherence) related to treatment adherence. Between-group comparisons and regression analyses were performed.

          RESULTS

          Fisher’s least significant difference (LSD) test showed significant differences between the Italian and Polish groups in all questionnaires ( p < .01) with the Italian patients reporting more satisfactory scores. Younger age (β = .08, p = .045), female gender (β = 1.03, p = .042), higher medication refills adherence (β = –.07, p = .024), lower intentional non-adherence (β = –.03, p = .009), positive beliefs about medications (β = .13, p < .001), better quality of communication with the physician (β = .09, p < .001), and stronger perceived medication-specific social support (β = .06, p = .001) were significantly associated with self-efficacy related to treatment adherence.

          CONCLUSIONS

          Future research and interventions should leverage psychosocial and behavioral factors to address self-efficacy contributing to enhancing adherence to clinical prescriptions.

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          Most cited references50

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          G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences

          G*Power (Erdfelder, Faul, & Buchner, 1996) was designed as a general stand-alone power analysis program for statistical tests commonly used in social and behavioral research. G*Power 3 is a major extension of, and improvement over, the previous versions. It runs on widely used computer platforms (i.e., Windows XP, Windows Vista, and Mac OS X 10.4) and covers many different statistical tests of the t, F, and chi2 test families. In addition, it includes power analyses for z tests and some exact tests. G*Power 3 provides improved effect size calculators and graphic options, supports both distribution-based and design-based input modes, and offers all types of power analyses in which users might be interested. Like its predecessors, G*Power 3 is free.
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            2018 ESC/ESH Guidelines for the management of arterial hypertension

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              Correlation Coefficients

              Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from -1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients.
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                Author and article information

                Contributors
                Role: Study design, Manuscript preparation, Literature search
                Role: Data collection, Manuscript preparation, Literature search
                Role: Manuscript preparation, Literature search
                Role: Data collection, Manuscript preparation
                Role: Statistical analysis
                Role: Statistical analysis, Data interpretation
                Role: Data collection
                Role: Data collection
                Role: Data collection
                Role: Study design, Data collection, Funds collection
                Journal
                Health Psychol Rep
                Health Psychol Rep
                HPR
                Health Psychology Report
                Termedia Publishing House
                2353-4184
                2353-5571
                09 March 2023
                2023
                : 11
                : 3
                : 188-199
                Affiliations
                [1 ]Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
                [2 ]Department of Psychology, University of Milano-Bicocca, Milan, Italy
                [3 ]Department of Cardiac Respiratory Rehabilitation of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
                [4 ]Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Wroclaw, Poland
                [5 ]IV Military Clinical Hospital of Wroclaw, Wroclaw, Poland
                [6 ]Respiratory Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
                [7 ]Cardiological Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
                [8 ]Neuromotor Rehabilitation Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
                [9 ]Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
                Author notes
                CORRESPONDING AUTHOR – Francesco Zanatta, Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy, e-mail: francesco.zanatta@ 123456unimib.it
                Author information
                https://orcid.org/0000-0002-4678-781X
                https://orcid.org/0000-0002-6995-4190
                https://orcid.org/0000-0001-9743-6684
                https://orcid.org/0000-0002-3428-668X
                https://orcid.org/0000-0001-8384-7060
                https://orcid.org/0000-0003-1120-3535
                Article
                159284
                10.5114/hpr/159284
                10670798
                38084262
                c3c5a931-3deb-4028-80a8-8fcd68c19f06
                Copyright © Institute of Psychology, University of Gdansk

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License ( http://creativecommons.org/licenses/by-nc-sa/4.0/)

                History
                : 01 June 2022
                : 23 August 2022
                : 13 January 2023
                Categories
                Original Article

                adherence,self-efficacy,type 2 diabetes mellitus,hypertension,chronicity

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