Relationship between Disease Adaptation and Self-Efficacy for Disease Management in Individuals with Multiple Chronic Diseases

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  • Asude GÜNEY Arş. Gör.
  • Gülden BASİT Doktora, Yrd. Prof.



Disease adaptation, Multiple chronic diseases, Non-communicable diseases, Self-efficacy


Aim: This study examines the relationship between disease adaptation and self-efficacy in managing multiple chronic diseases.

Materials and Methods: This descriptive and correlational study was conducted from December 1st to December 31st, 2022, in the internal clinics of a university hospital in Konya. The population of the research consisted of individuals with multiple chronic diseases hospitalized at Necmettin Erbakan University Faculty of Medicine Hospital, and the sample consisted of 230 patients who met the criteria for inclusion in the research. Data collection utilised the Patient Information Form, the Assessment Scale for Adaptation to Chronic Diseases, and Self-Efficacy for Managing Chronic Disease 6-Item Scale. Data analysis employed the Mann-Whitney U test, Kruskal-Wallis H test, Dunn test, and descriptive statistics. Linear regression analysis was used to analyse the factors affecting the 6-item self-efficacy scale score for chronic disease management. Analysis results were presented as mean ± standard deviation and median (minimum-maximum) for quantitative data, and as frequency and percentage for categorical data.

Results: It was determined that 64.8% of the individuals were women, 83% were married, and 71.7% were primary school graduates. The mean level of adaptation with chronic diseases was 62.48 ± 9.81, while the mean self-efficacy level was 4.58 ± 2.01. Those who were married had a higher level of education, were employed, had a good income, lived in larger families and urban areas, and had two chronic diseases exhibited higher adaptation to chronic disease. A significant correlation was found between the total scores of the scales.

Conclusions: In conclusion, as individuals' adaptation levels to chronic diseases increase, their chronic disease management self-efficacy levels also increase. It is recommended to conduct qualitative studies examining individuals' adaptation to chronic diseases, self-efficacy and affecting factors, and to conduct multicenter studies evaluating the adaptation and self-efficacy of individuals with multiple chronic diseases


Acaroğlu Değirmenci, G. (2019). Development and implementation of chronic illness adaptation scale. (Doktora Tezi). Yöktez. Tez No: 538750.

Akpınar, N. B., Ceran, M. A. (2019). Chronic diseases and rehabilitation nursing. Journal of Adnan Menderes University Health Sciences Faculty, 3(2):140-152.

Allam, M. M., El-Zawawy, H. T., Ismail, I. I., Ghazy, R. M. (2020). Cross-cultural reliability of an arabic version of the self-efficacy for managing chronic disease 6-item scale in arab patients with diabetes mellitus. Primary Care Diabetes, 14(4):305-310. doi:10.1016/j.pcd.2019.11.001

Almeida, J. A. B., Florêncio, R. B., Lemos, D. A., Leite, J. C., Monteiro, K. S., Gualdi, L. P. (2022). Self-efficacy instruments for individuals with coronary artery disease: a systematic review protocol. BMJ Open, 12(7):e062794. doi:10.1136/ bmjopen-2022-062794

Aslan, H., Çetkin, T., Demir, R. (2021). Effects of chronic illness adaptation on the healthy lifestyle behaviours of patients in internal services. Cukurova Medical Journal, 46(3):1140-1149. doi:10.17826/cumj.913997

Aydemir, T., Çetin, Ş. (2019). Chronic diseases and psychosocial care. Journal of Anatolian Medical Research, 4(3):109-115.

Bähler, C., Huber, C. A., Brüngger, B., Reich, O. (2015). Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. BMC Health Services Research, 15:1-12. doi: 10.1186/s12913-015-0698-2

Bakan, G., Inci, F. H. (2021). Predictor of self‐efficacy in individuals with chronic disease: Stress‐coping strategies. Journal of Clinical Nursing, 30(5-6):874-881. doi:10.1111/jocn.15633

Bakır, G. G., Zengin, N. (2023). Investigation of self-management and affecting factors in individuals with diabetes. Journal of Health and Life Sciences, 5(1):9-17. doi:10.33308/2687248X.202351289

Bandura, A.Social cognitive theory: An agentic perspective. Asian Journal of Social Psychology, 2(1):21-41. doi:10.1111/1467-839X.00024

Bilgiç, Ş., Pehlivan, E. (2023). The relationship of adaptation to the disease and quality of life of individuals with chronic disease. Journal of Samsun Health Sciences, 8(1):63-76. doi:10.47115/jshs.1088222

Bulut, S., Kafadar, D., Yakupoğlu, E., Okuyan, E. (2020). Evaluation of the association of medication adherence with polypharmacy and multimorbidity in patients with coronary artery disease. Ankara Medical Journal, 20(4):777-789. doi:10.5505/amj.2020.67044

Ceyhan, Y. Ş., Ünsal, A. (2018). Comparison of the self-efficacy level of the people with different chronic diseases. DEUHFED, 11(4):263-273.

Chen, J., Tian, Y., Yin, M., Lin, W., Tuersun, Y., Li, L., Yang, J., … He, F. (2023). Relationship between self-efficacy and adherence to self-management and medication among patients with chronic diseases in China: A multicentre cross-sectional study. Journal of Psychosomatic Research, 164, 111105.

Daniali, S. S., Darani, F. M., Eslami, A. A., Mazaheri, M. (2017). Relationship between self-efficacy and physical activity, medication adherence in chronic disease patients. Advanced Biomedical Research, 6. doi:10.4103/2277-9175.190997

Demirbas, N., Kutlu, R. (2020). Treatment adherence and self-efficacy levels of adults using multiple drugs. Ankara Medical Journal, 20(2)doi:10.5505/amj.2020.16362

Demirkol, M. E., Tamam, L. (2016). Treatment adherence in psychiatric disorders. Current Approaches in Psychiatry, 8(1):85-93. doi:10.18863/pgy.49806

Duran, Ş. B, Keser, İ. (2021). In the treatment and care of chronic diseases use of hope therapy. Journal of Social Research and Behavioral Sciences, 7(13).

Ebrahimi Belil, F., Alhani, F., Ebadi, A., Kazemnejad, A. (2018). Self-efficacy of people with chronic conditions: A qualitative directed content analysis. Journal of Clinical Medicine, 7(11):411. doi:10.3390/jcm7110411

Eslami, A., Daniali, S. S., Mohammadi, K., Reisi-Dehkordi, N., Mostafavi-Darani, F. (2017). Cultural adaptation and psychometric properties of the persian version of self-efficacy in chronic disease patients. Iranian Journal of Nursing and Midwifery Research, 22(1):57. doi:10.4103/1735-9066.202065

Fan, X., Lv, F. (2016). Psychosocial factors associated with self-efficacy for managing chronic disease in patients with chronic heart failure. European Journal of Cardiovascular Nursing, 15(4):255-261. doi:10.1177/1474515114566157

Graff, L. A., Sexton, K. A., Walker, J. R., Clara, I., Targownik, L. E., Bernstein, C. N. (2016). Validating a measure of patient self-efficacy in disease self-management using a population-based IBD cohort: The IBD self-efficacy scale. Inflammatory Bowel Diseases, 22(9):2165-2172. doi:10.1097/MIB.0000000000000856

Gruber-Baldini, A. L., Velozo, C., Romero, S., Shulman, L. M. (2017). Validation of the PROMIS® measures of self-efficacy for managing chronic conditions. Quality of Life Research, 26:1915-1924. doi:10.1007/s11136-017-1527-3

Health, M. O. (2021). Türkiye non-communicable diseases and risk factors cohort study.

İncirkuş, K., Nahcivan, N. (2020). Validity and reliability study of the Turkish version of the self-efficacy for managing chronic disease 6-item scale. Turkish Journal of Medical Sciences, 50(5):1254-1261. doi:10.3906/sag-1910-13

Institute, T. S. (2018). TUIK Death Statistics.

Kacaroğlu Vicdan, A., Birgili, F. (2018). The validity and reliability study for developing an assessment scale for adaptation to chronic diseases. Journal of Current Researches on Health Sector, 8(2):135-144. doi:10.26579/jocrehes_8.2.13.27.

Koşar, C., Besen, D. B. (2015). Patient activation in chronic diseases: concept analyse. DEUHFED, 8(1):45-51.

Kütmeç Yılmaz, C., Kara, F. Ş. (2021). The effect of spiritual well-being on adaptation to chronic illness among people with chronic illnesses. Perspect Psychiatr Care, 57:318-325. doi:10.1111/ppc.12566

Lorig, K. R., Sobel, D. S., Ritter, P. L., Laurent, D., Hobbs, M. (2001). Effect of a self-management program on patients with chronic disease. Effective Clinical Practice, 4(6):256-262.

Marconcin, P., Tomé, G., Carnide, F., Yazigi, F., Campos, P., Pais, S., Espanha, M. (2021). Translation, cultural adaptation and validation of the self-efficacy to manage chronic disease 6-item scale for european Portuguese. Acta Reumatologica Portuguesa, 46(1):15-22. doi:10.1038/npjpcrm.2016.87

Oktar, D., Çam, C., Zencirci, S. A., Aygar, H., Dağtekin, G., Çalışkan Pala, S., … Metintaş, S. (2021). Evaluation of the relationship of chronic disease, multimorbidity and quality of life at primary health care centers. Turkish Journal of Public Health, 19(2):116-128. doi:10.20518/tjph.765900

Özdelikara, A., Taştan, A., Atasayar, B. Ş. (2020). Assessment of self-care management and compliance in chronic diseases. Journal of Samsun Health Sciences, 5(1):42-49.

Peters, M., Potter, C. M., Kelly, L., Fitzpatrick, R. (2019). Self-efficacy and health-related quality of life: a cross-sectional study of primary care patients with multi-morbidity. Health and Quality of Life Outcomes, 17:1-11. doi:10.1186/s12955-019-1103-3

Rostagni, O. M., Stutts, L. A. (2023). Gratitude, self-efficacy, and health-related quality of life in individuals with Parkinson’s disease. Psychology, Health & Medicine, 28(5):1160-1166. doi:10.1080/13548506.2022.2058032

Sadler, E., Wolfe, C. D., Jones, F., McKevitt, C. (2017). Exploring stroke survivors' and physiotherapists' views of self-management after stroke: a qualitative study in the UK. BMJ Open, 7(3):e011631. doi:10.1136/ bmjopen-2016-011631

Sarhan, S. A, Kamal, D. E, Hamed, M. S., Mostafa, D. I. (2022). Validity and reliability of the Arabic version of the self-efficacy for managing chronic disease scale in rheumatoid arthritis patients. Clinical Rheumatology, 41(10):2967-2975. doi:10.1007/s10067-022-06183-2

Şentürk, S. G. (2021). The importance of self-management strategies and the role of nurses in the management of chronic diseases. Eurasian Journal of Health Sciences, 4(1):9-13.

Topçu, S., Oğuz, S. (2017). Self-efficacy and quality of life after stroke. Journal of Human Sciences, 14(2):1388-1396. doi:10.14687/jhs.v14i2.4503

Violán, C., Foguet-Boreu, Q., Fernández-Bertolín S, Guisado-Clavero, M., Cabrera-Bean, M., Formiga, F., …Roso-Llorach, A. (2019). Soft clustering using real-world data for the identification of multimorbidity patterns in an elderly population: cross-sectional study in a Mediterranean population. BMJ Open, 9(8):e029594. doi:10.1136/bmjopen-2019- 029594

WHO (2019). Noncommunicable diseases.

WHO (2022). Noncommunicable disease keys facts.

Yılmazel, G., Duman, N. (2018). Polypharmacy and comorbidities among elderly women. Journal of Continuing Medical Education, 27(2):80-85.

Yuan,Y., Xu, H. W., Zhang, S., Wang, Y., Kitayama, A., Takashi, E., … Liang, J. Y. (2021). The mediating effect of self‐efficacy on the relationship between family functioning and quality of life among elders with chronic diseases. Nursing Open, 8(6):3566-3574. doi:10.1002/nop2.906

Zulman, D. M., Chee, C. P, Wagner, T. H, Yoon, J., Cohen, D. M., Holmes, T. Y., …Asch, S. M. (2015). Multimorbidity and healthcare utilisation among high-cost patients in the US Veterans affairs health care system. BMJ Open, 5(4):e007771. doi:10.1136/bmjopen-2015-007771




How to Cite

GÜNEY, A., & BASİT, G. (2023). Relationship between Disease Adaptation and Self-Efficacy for Disease Management in Individuals with Multiple Chronic Diseases. GEVHER NESIBE JOURNAL OF MEDICAL AND HEALTH SCIENCES, 8(4), 1191–1201.




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