Attitude, Social Influence, and Self-Efficacy Among Chinese Participants of Chronic Disease Self-Management Program: A Latent Growth Curve Modeling Study

This study aimed to examine temporal relationships among psychological parameters (readiness to change, changes in self-efficacy [SE], social norm [SN], attitude [AT]) and two self-management behaviors: cognitive symptom management (CSM) and tangible help-seeking (TH) by constructing latent growth change models. Method: This was a longitudinal study of 60 Chinese participants with various chronic diseases who completed a 6-week chronic disease self-management program. Psychological and behavioral variables were assessed at the beginning of the 1st, 4th, and 6th week of the program. Results: Latent growth change curve analysis revealed that, in the early stages of engagement in CSM, SE was a key determinant of behavior. During the 6-week period, changes in SE were influenced directly by both SN and AT. When engaging in TH, SE influenced the behavior with direct and indirect effect from AT and SN. Readiness for change, on the other hand, appeared to be more associated with psychological rather than behavioral changes. This study revealed different underlying change mechanisms for two types of self-management behaviors. Conclusion: The findings shed light on program modifications that could further strengthen the therapeutic effects of the program.