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The Relationships Among Health Literacy, Stigma, Self-efficacy, Self-care, and Health Outcomes in Patients with Sickle Cell Disease

O'Brien, Julia Ann
http://orcid.org/0000-0002-3208-3344
http://rave.ohiolink.edu/etdc/view?acc_num=case1619721246113378

Abstract Details

2021, Doctor of Philosophy, Case Western Reserve University, Nursing.
Sickle cell disease (SCD) is an autosomal recessive disorder that affects approximately 100,000 Americans. Symptoms begin during infancy and progress throughout an individual, often shortened, lifespan. Self-care may optimize symptom management and delay chronic complications; self-efficacy is also linked to better health outcomes in many chronic disease populations, and there is emerging evidence that self-efficacy has a positive impact on health for patients living with SCD. However, little is known about potential psychosocial predictors of self-care actions and self-efficacy in adults living with SCD. Further study is needed to explore how the relationship between causal factors, including perceived stigma and health literacy, and health outcomes, such as pain interference and health related quality of life (HRQOL), is mediated by self-efficacy and self-care actions. The purpose of this study was to develop a model examining the relationships among patient factors, self-care management resources, and health outcomes in patients with SCD. Individual and family self-management theory and the theory of self-care management for sickle cell disease were used to frame the study. This study was a descriptive, cross-sectional study including a convenience sample of 60 adults diagnosed with SCD. Analysis included Pearson product-moment correlations and linear regression to address the study questions. Perceived stigma had significant relationships with self-efficacy (r = -.322, p < .01), pain interference (r = .430, p < .01), physical HRQOL (r = -.505, p < .01), and mental HRQOL (r = -.382, p < .01), and self-efficacy had significant relationships with physical HRQOL (r = .449, p < .01) and pain interference (r = -.353, p < .01). Linear regression supported mediation of the relationship between perceived stigma and physical HRQOL by self-efficacy, even when depressive symptoms were accounted for. This study furthered SCD knowledge by exploring both stigma and health literacy and their relationships to self-efficacy, self-care, and health outcomes in patients with SCD. Examining a more extended model in patients with SCD created the foundation for future intervention studies that could improve self-efficacy and teach coping behaviors to reduce the impact of perceived stigma as well as decrease stigmatizing behaviors from health care providers.
Ronald Hickman, PhD (Committee Chair)
Mary Dolansky, PhD (Committee Member)
Christopher Burant, PhD (Committee Member)
Susan Padrino, MD (Committee Member)
160 p.
Nursing
sickle cell disease; self-care; self-efficacy; health-related quality of life; pain interference; stigma; perceived stigma; health literacy; SCD; sickle cell anemia; SCA;

Recommended Citations

Citations

  • O'Brien, J. A. (2021). The Relationships Among Health Literacy, Stigma, Self-efficacy, Self-care, and Health Outcomes in Patients with Sickle Cell Disease [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1619721246113378

    APA Style (7th edition)

  • O'Brien, Julia. The Relationships Among Health Literacy, Stigma, Self-efficacy, Self-care, and Health Outcomes in Patients with Sickle Cell Disease. 2021. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1619721246113378.

    MLA Style (8th edition)

  • O'Brien, Julia. "The Relationships Among Health Literacy, Stigma, Self-efficacy, Self-care, and Health Outcomes in Patients with Sickle Cell Disease." Doctoral dissertation, Case Western Reserve University, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1619721246113378

    Chicago Manual of Style (17th edition)

case1619721246113378
277
© 2021, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.
Release 3.2.12