Relationship between self-efficacy and adherence to self-management and medication among patients with chronic diseases in China: A multicentre cross-sectional study

This study aimed to explore the effects of self-efficacy on adherence to self-management and medication among patients with chronic diseases in China. A cross-sectional survey of 2047 patients with chronic diseases in 120 cities across China was conducted between May and September 2021 using a multi-stage sampling method. Self-efficacy was measured using the New General Self-Efficacy Scale. The adherence to self-management was measured using the item response theory based self-management adherence scale, and the medication adherence was assessed using the Medication Adherence Scale for the Chronically Ill. The adherence to self-management and medication were evaluated by linear regression and logistic regression models, respectively. After adjusting for all covariates, self-efficacy was significantly associated with adherence to self-management (β =0.207, 95% CI =0.064–0.350, P = 0.005), but not with medication adherence (for[middle/low]: OR = 1.119, 95% CI =0.828–1.511, P = 0.47; for[high/low]: OR = 1.281, 95% CI =0.935–1.754, P = 0.12). In subgroup analysis, self-efficacy positively correlated with adherence to self-management in patients with multiple chronic diseases (β =0.286, 95% CI =0.037–0.535, P = 0.03), but not in those with only one chronic disease (P = 0.12). Self-efficacy was not significantly associated with medication adherence in any of the subgroups. Self-efficacy was positively associated with adherence to self-management in patients with chronic diseases, but not with medication adherence. Enhanced health education in patients with one chronic disease alone may have an association with better adherence to self-management and medication in daily life.