Comparative study of PROMISⓇ self-efficacy for managing chronic conditions across chronic neurologic disorders
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Published on: August 25, 2022
Lisa M Shulman1, Craig Velozo2, Sergio Romero3,4
1Department of Neurology, University of Maryland School of Medicine, 110 S. Paca Street, Rm 3-S-127, Baltimore, MD, 21201-1559, USA. lshulman@som.umaryland.edu.
Purpose:
Self-efficacy (SE) for managing chronic conditions is the belief that one can carry out behaviors to reach health goals. The study objective is to investigate (1) SE for managing chronic conditions across diverse neurologic conditions, (2) demographic and disease determinants of SE, and (3) SE as a predictor of health and disability.
Methods:
Patients with chronic neurologic conditions (epilepsy, multiple sclerosis, neuropathy, Parkinson disease, stroke; n = 834) completed five SE for Managing Chronic Conditions instruments (Patient-Reported Outcomes Measurement Information System®; PROMIS®). Other assessments included PROMIS depression, fatigue, physical function, and global health.
Results:
Two of the five SE domains showed differences across the five disorders (ANOVA; SE for Managing Daily Activities p < .001 and Managing Symptoms p < .01). The three domains with no differences were Managing Medications/Treatments, Emotions, and Social Interactions. Lowest SE was in neuropathy, and highest in epilepsy (Managing Activities) and stroke (Managing Symptoms). Multivariate regression showed SE measures to be better predictors of mental health, global health, and disability than either disease severity or diagnosis.
Conclusions:
SE for managing chronic conditions differs across neurologic disorders, with lowest SE for managing activities and symptoms in neuropathy, and highest in patients with epilepsy and stroke. PROMIS SE measures are better predictors of mental health, disability, and quality of life than disease severity or diagnosis.
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