Decision self-efficacy and its determinants among Chinese adults with pneumoconiosis: a cross-sectional study

Decision self-efficacy is a key component of effective self-management in chronic diseases, yet little is known about its status and determinants among patients with pneumoconiosis. This study aimed to assess decision-making self-efficacy and identify its socio-demographic and clinical predictors in Chinese adults with pneumoconiosis.

A cross-sectional survey was conducted among 268 patients with pneumoconiosis recruited from a tertiary hospital in Ganzhou, China. Data were collected using a general demographic questionnaire and the Chinese version of the Decision-Making Self-Efficacy Scale. Independent-samples t-tests, one-way analysis of variance, and multiple linear regression analyses were performed to assess the levels and determinants of decision-making self-efficacy, including interactions between key socio-economic factors.

The mean decision-making self-efficacy score among patients with pneumoconiosis was 56.75 ± 17.54, indicating a moderate-to-low level. Greater decision-making self-efficacy was significantly associated with higher educational level and higher monthly income. In contrast, advanced disease stage, being widowed or divorced, home oxygen therapy, and anxiety were linked to lower self-efficacy. A significant interaction between education and income indicated that the beneficial effect of education was amplified among higher-income patients (P for interaction = 0.033).

Decision-making self-efficacy among patients with pneumoconiosis is suboptimal and influenced by socio-economic, clinical, and psychosocial factors. Individualized decision-support strategies should be developed to enhance patients' decision-making self-efficacy and promote active participation in treatment decision-making, particularly for patients with lower education or income, advanced disease, or limited social support.