Influence of Health Education Exposure and Self-Efficacy with Self-Management Practices Among Patients with Hypertension and Diabetes at Rivers State University Teaching Hospital, Port Harcourt, Nigeria

Hypertension (HTN) and diabetes mellitus (DM) require sustained self-management, but evidence on how health education exposure and self-efficacy relate to self-management among patients in Nigerian tertiary hospitals remains limited. This study examined the associations of health education exposure and self-efficacy with self-management practices among 400 adults with hypertension, type 2 diabetes mellitus, or both conditions attending Rivers State University Teaching Hospital, Port Harcourt. Data from an interviewer-administered cross-sectional survey were analysed using descriptive statistics, chi-square tests, multivariable logistic regression, pooled and penalised sensitivity estimates, and an exploratory propensity score matching (PSM) covariate-balance analysis. Overall, 71.5% of respondents reported receiving health education in the previous six months, whereas good self-management (composite score ≥35 of 50) was reported by 28.0% of hypertension-only, 27.8% of diabetes-only, and 27.5% of comorbid participants. Good self-management was more prevalent among participants with moderate/high than low health education exposure (absolute difference 24.5–28.2 percentage points across the three groups; Mantel–Haenszel pooled odds ratio 5.67, 95% CI 2.84–11.33) and among those with high than low self-efficacy. In group-specific adjusted models, high health education exposure (AOR 5.56–10.12) and high self-efficacy (AOR 4.02–5.42) were associated with greater odds of good self-management; these estimates were strong yet imprecise, particularly in the diabetes-only group (25 participants with good self-management). Because exposure and outcome were measured concurrently, all findings represent associations that may be affected by reverse causation, self-report bias and residual confounding; they do not demonstrate causal effects or the effectiveness of any intervention. The findings support further evaluation of structured health education and self-efficacy-enhancing strategies within routine chronic disease care.