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The Influence of Perception on Self-Efficacy Among Patients with Coronary Artery Disease in Indonesia: A Rasch
Aan Nuraeni1, Firman Sugiharto2, Anastasia Anna1
1Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia.
Background:
The prevalence of Coronary Artery Disease (CAD) in Indonesia continues to rise, necessitating practical management approaches. Self-efficacy (SE) is critical in supporting CAD patients' autonomy in managing their condition. Patients' perceptions of their disease significantly influence decision-making and health management behaviours.
Purpose:
This study aimed to identify the influence of perceptions on self-efficacy in managing CAD among diagnosed patients.
Patients And Methods:
A cross-sectional study design was employed among 102 adult patients with CAD. The sample was selected using convenience sampling based on predefined inclusion and exclusion criteria. Data were collected using the Health Belief Related to Cardiovascular Disease (HBCVD) Scale to assess perceived susceptibility, severity, benefits, and barriers; the Health Belief Model instrument to evaluate cues to action; and the Self-Efficacy Questionnaire for Coronary Heart Disease Management to measure self-efficacy (SE). The scale has been validated and demonstrated strong psychometric properties (validity ≥ 0.7, reliability ≥ 0.8). The Rasch model approach was employed in this study, with data analysis conducted using Pearson correlation and simple linear regression.
Results:
A total of 91.2% of respondents exhibited high levels of SE. The mean logit scores for CAD management-related perceptions were as follows: perceived severity (0.494 ± 1.28), perceived susceptibility (-0.961 ± 3.06), perceived barriers (0.261 ± 1.00), perceived benefits (3.68 ± 2.25), cues to action (0.968 ± 1.17), and perception (0.544 ± 0.668). The analysis revealed a significant relationship between perceptions and SE (p<0.001). Perceived severity and perceived barriers emerged as the most influential predictors of SE, with an adjusted R² = 0.899 and a standardized estimate of 0.949 (95% CI = 0.886-1.01; p<0.001).
Conclusion:
Perceived severity and perceived barriers significantly influence self-efficacy in CAD patients. These findings provide a foundation for healthcare professionals to design perception-based interventions, such as health education and personalized counselling, to enhance SE within this population.
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