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Published on: April 19, 2019
Self-Care Agency in Cardiovascular Care: A Cross-Sectional Study on the Interplay Between Self-Efficacy, Loneliness
Tino Prell1,2, Lisa Bauer2, Roland Prondzinsky3
1Department of Geriatrics, Jena University Hospital, 07747 Jena, Germany.
Background:
Appraisal for self-care agency (ASAS) is central to cardiovascular disease (CVD) management, yet the influence of loneliness as a social stressor remains under-characterized.
Methods:
In patients with CVD (N = 80), cross-sectional predictors for ASAS were assessed via ordinary least squares (OLS) and quantile regression; robust methods are supplemented to buffer the sample size. Interaction effects on ASAS were tested between loneliness and physical activity, and loneliness and self-efficacy.
Results:
The diminishing effect of loneliness explained 10% of ASAS variance and remained significant when controlling for covariates (ß = -1.05, p = 0.031). Self-efficacy (β = 2.97, p = 0.009) and physical activity (β = 5.13, p = 0.001) were positively associated with ASAS, although quantile models indicated heterogeneity: loneliness exerts its effect at low ASAS (τ = 0.25; ß = -1.95, p < 0.001) whereas physical activity is influential at high ASAS (τ = 0.75; ß = 5.21, p < 0.001) and self-efficacy across all levels. Interactions showed a buffering of loneliness' negative influence on ASAS via physical activity (ß = 3.29, p = 0.044).
Conclusions:
Self-efficacy is crucial for self-care agency in CVD. While loneliness exerts its strongest detriment at lower self-care levels, physical activity may attenuate loneliness-related vulnerability. These findings support interventions enhancing self-efficacy, promoting activity, and targeting loneliness to improve self-care.
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