Trajectories of self-efficacy in persons with chronic illness: An explorative longitudinal study

BACKGROUND: Self-efficacy is important for changing health behaviour in persons with chronic illness. Longer term trajectories have not been previously explored. OBJECTIVE: This study's objective was to explore the trajectories of self-efficacy in two different groups with chronic illnesses attending a patient education course. DESIGN: The study design was a longitudinal, comparative cohort study with five time points during a one-year follow-up, using repeated measures analysis of variance. SETTING AND PARTICIPANTS: Persons with morbid obesity (n = 55) and persons with chronic obstructive pulmonary disease (COPD; n = 56) were recruited at the start of patient education courses in Norway and followed-up four times the following year. MAIN OUTCOME MEASURE: The General Self-Efficacy Scale was the main outcome. RESULTS: Obese persons showed a linear pattern of increasing self-efficacy during the follow-up period, whereas persons with COPD had an initial increase followed by a decrease in self-efficacy. Having paid work was associated with a more positive self-efficacy trajectory. CONCLUSION: The results provide support for the currently employed patient education course for morbidly obese persons. In contrast, persons with COPD may need more extensive and/or more frequent support in order to increase and maintain self-efficacy across time.