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Self-Efficacy as a Predictor of Adult Adjustment to Sickle Cell Disease: One-Year Outcomes

Departments of Psychology (R.E.) and Maternal and Child Health (J.T., H.C.) and School of Nursing (J.L.), University of Alabama at Birmingham, Birmingham, Alabama.

Address reprint requests to: Joseph Telfair, DrPH, MSW, University of Alabama at Birmingham, 1530 3rd Avenue South, RPHB 320, Birmingham, AL 35294-0022. Email: jtelfair{at}uab.edu

OBJECTIVE: The present study prospectively investigated the role of self-efficacy in predicting disease symptomatology and health services utilization for adult patients with sickle cell disease.

METHODS: These data are derived from a 12-month prospective cohort study of African American adults with sickle cell disease. Disease-specific perceptions of coping self-efficacy and indices of disease severity, health care utilization, and psychosocial adjustment were assessed by use of standardized questionnaires administered by trained clinicians.

RESULTS: Perceptions of self-efficacy for coping with sickle cell disease were moderately stable across the 12-month study period. At baseline (N = 147), significant inverse relationships, measured with Pearson correlations, were noted between self-efficacy and the following variables: physical symptoms, psychological symptoms, pain severity, and number of physician visits over the preceding 12 months (p < .01). Similar relationships with self-efficacy were noted at the 1-year follow-up (N = 104) period for measures of physical symptoms, psychological symptoms, and pain severity (p < .01). In multiple-regression models, baseline self-efficacy scores predicted changes over the 1-year study period in physical and psychological sickle cell disease symptomatology. Moreover, changes in self-efficacy from baseline to 1-year follow-up were significantly and independently related to changes in physical symptoms, psychological symptoms, and pain ratings from baseline to 1-year follow-up.

CONCLUSIONS: Self-efficacy beliefs among African American adults with sickle cell disease are inversely related to reported disease symptomatology, and these relationships persist across time. Future investigations should examine the mechanisms through which relationships between self-efficacy and adjustment to sickle cell disease are effected, as well as the feasibility and effectiveness of enhancing self-efficacy beliefs as a means of improving adjustment to sickle cell disease.

Key Words: sickle cell disease • self-efficacy • chronic illness • longitudinal

Abbreviations: SCD = sickle cell disease; SCSES = sickle cell self-efficacy scale

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