Higher self-efficacy predicted better medication adherence (β = -0.345, p < 0.001), a relationship partially mediated by perceived stress (indirect effect β = -0.063, p = 0.003).
Cross-Sectional (n=270)
No
In patients with heart failure, higher self-efficacy is associated with reduced perceived stress, which in turn partially mediates better medication adherence.
Effect estimate: β -0.345
p-value: p=<0.001
Introduction: Understanding how self-efficacy relates to medication adherence is crucial for patients with heart failure. This study investigated how stress mediates the relationship between self-efficacy and adherence to prescribed medication in patients with heart failure. Methods: This study employed a cross-sectional descriptive design. Using convenience sampling, 270 participants were recruited from the outpatient cardiology clinic in one of the largest hospitals in Aseer region, Saudi Arabia. Participants completed self-administered questionnaires, including the Perceived Stress Scale (PSS), Cardiac Self-Efficacy Scale (CSES), and Adherence to Refills and Medications Scale (ARMS). The data collection was conducted from January 2025 and ended in May 2025. Results: Results showed moderate stress (Mean = 20.17), high self-efficacy (Mean = 44.90), and a tendency toward medication non-adherence (Mean = 23.38). Stress was positively correlated with medication non-adherence (r = 0.392, p < 0.01), while self-efficacy was the strongest predictor of adherence (β = −0.345, p < 0.001). Mediation analysis confirmed that perceived stress partially mediates the relationship between self-efficacy and medication adherence (indirect effect β = −0.063, p = 0.003). Conclusions: Higher self-efficacy reduces perceived stress, which in turn leads to better medication adherence. From a nursing perspective, clinical practice should shift toward a “confidence-based” model of care. Routine psychological screening and targeted, demographic-specific interventions—particularly for younger patients and those with multiple comorbidities—are essential to empower patients and improve long-term health outcomes.
Benjamin et al. (Thu,) conducted a cross-sectional in Heart failure (n=270). Self-efficacy was evaluated on Medication adherence (β -0.345, p=<0.001). Higher self-efficacy predicted better medication adherence (β = -0.345, p < 0.001), a relationship partially mediated by perceived stress (indirect effect β = -0.063, p = 0.003).