[[alternative]]The relationship between self-efficacy, social support and self management behaviors among patients with knee osteoarthritis

[[abstract]]背景及目的：退化性膝關節炎是中老年人最常見的慢性、退化性疾病，也是導致疼痛與失能的原因之一，限制了患者活動能力，造成身體功能不良的預後及失能，影響個人經濟收入以及社會角色參與的能力。如何減緩退化性膝關節炎的惡化程度是近幾年被重視的議題，因此以患者為中心的自我管理概念逐漸受到重視。本研究目的為探討退化性膝關節炎患者之自我效能、社會支持與自我管理行為之相關性及探討自我效能之中介作用。方法：採橫斷式研究設計，以方便取樣方式針對北部某區域醫院門診之退化性膝關節炎患者進行調查，共收回 140 份問卷。研究工具使用「關節炎疾病嚴重度量表」、「關節炎自我效能量表」、「社會支持行為量表」及「關節炎自我管理評估工具」。以 SPSS 21.0 統計軟體進行描述性統計、獨立樣本 t 檢定、單因子變異數、皮爾森積差相關及多元迴歸之統計分析。 結果：研究對象之自我效能、社會支持與自我管理行為呈顯著正相關；迴歸分析顯示教育程度 (β = .226, p < .05)、自我效能 (β = .306, p < .01)、行動化支持(β = .335, p < .001)為自我管理行為之重要預測因子，可解釋總變異量 38.9%。層級迴歸分析驗證自我效能對知覺性社會支持與自我管理行為之間具有部分中介效果。 結論：本研究支持自我效能、社會支持與自我管理行為之相關性，依研究結果建議臨床醫護人員應提供個別化疾病照護資訊的及社會支持，提升患者自我效能之信心，增進退化性膝關節炎患者執行自我管理行為，尤其針對低等教育程度、自我效能信心不足以及缺乏社會支持之患者，以期改善關節炎症狀，延緩關節退化。[[abstract]]Background and purpose: Knee osteoarthritis (KOA) is the most common chronic and degenerative disease in the middle-aged and elderly people. It is also one of the causes of pain and disability, which limits the mobility of patients, results in poor prognosis and disability of physical function, and affects personal income and social participation, increasingly importance has been attached to how to keep their disease at bay in recent years. Therefore, the concept of patient-centered self-management behaviors has gradually attracted attention. The purpose of this study was to investigate the relationship between self-efficacy, social support and self-management behaviors among patients with KOA and to explore the mediating role of self-efficacy.Methods: A cross-sectional study design and convenience sampling was employed on patients with KOA. 140 questionnaires were collected. The research instruments included the Western Ontario and MacMaster Osteoarthritis Index (WOMAC), the arthritis self-efficacy scale (ASE), inventory of socially supportive behavior (ISSB) and arthritis self-management assessment tool (ASMAT). SPSS 21.0 statistical software was used for descriptive statistics, independent-sample t-test, one-way ANOVA, Pearson’s correlation and multiple regression analysis.Results: The results showed that self-efficacy and social support of the subjects were significantly correlated with self-management behaviors. Multiple regression analysis showed that educational level (β = .226, p < .05), self-efficacy (β = .306, p < .01) and enacted support (β = .335, p < .001) were important predictors of self-management behaviors, which explained 38.9% of the total variance. Hierarchical regression analysis verified that self-efficacy had a partial mediating effect between perceived social support and self-management behaviour.Conclusion: This study confirmed the correlation between self-efficacy, social support and self-management behaviors, and suggested that clinical staffs should provide individual care information and social support to improve patients’self-efficacy, to improve the performance of self-management in patients with KOA, especially for patients with low educational level, low self-efficacy confidence and insufficient social support, in order to improve the symptoms of arthritis and delay joint degeneration