Application Of Self-efficacy Theory In Functional Constipation Patients With Biofeedback Treatment

Background:Functional constipation (FC) is one kind of common functional gastrointestinal diseases. The preva1ence of FC varies from 4 to l7 percent in ordinary people with the general tendency that is more common in female than in male, and in the old than in the young according to the domestic and international related reports. With the accelerated pace of modern life, eating habits, and social-psychological factors, the incidence of FC increases year by year, an unhealthy lifestyle has become an important cause of FC. The studies on FC have attracted more and more attention with the poor effect of traditional durgs, surgical treatment on a large amount of FC patients, and as well as the increasingly severe hazard brought by non-standard treatment.So far, the mechanism of FC is not all clear yet. Many research suggested that physiological and psychological dysfunction often coexist in patients with constipation, that is to say, FC has become a classic of psychosomatic illness in modern medical model. Recently, biofeedback training has become a newly rising treatment because of its advantages such as convience and safety. The patient's confidence and patience is the key to the success of treatment. From a clinical perspective, self-efficacy means the patients'confidence of self-management, and which can affect the selection and persistence of behaviors largely, and thereby improve health outcomes. Hence, it's important to help patients build up therapeutic confidence and perform good health behaviors.This paper is to investigate the level and related factors of self-efficacy and health behavior among FC patients, explore the effects of self-efficacy intervention on self-management behavior, health outcomes and satisfaction of FC patients and form effective and standardized intervention system.Objectives:1. To investigate the level and influencing factors of self-efficacy among FC patients.2. To investigate the level and influencing factors of health behavior among FC patients.3. To explore the effects of self-efficacy intervention on health behavior (compliance included), health outcomes (clinical syptoms, psychological condition and quality of life) and satisfaction of FC patients with biofeedback training.Materials and Methods:1. The survey of self-efficacy and health behavior: self-rated abilities for health practices scale(SRAHP) for self-efficacy and health-promoting lifestyle profile(HPLP) for health behavior were conducted through a convenience sample of 102 FC patients. In addition, a structured questionnaire for general data of patients such as demographic and clinical evaluation, Zung'self-rating anxiety scales (SAS) and self-rating depressive scales (SDS) for psychological condition, Chinese version of the MOS 36-item short form healthy survey (SF-36) for quality of life were also carried out to analyze the relationship between self-efficacy/health behavior and these variables.2. 61 FC patients with biofeedback training were given self-efficacy intervention (10 times). After accomplishing treatment, assess self-efficacy, health behavior (compliance included), health outcomes (clinical syptoms, psychological condition and quality of life) and satisfaction again. Statistics and analyses the parameters before and after interventions.Results:1. The total score of self-efficacy among FC patients was 62.13±16.68, and only 11. 8%(n=12) of them displayed high level of self-efficacy. The total score of self-efficacy was positively correlated with educational level and the SF-36 total score, while negatively correlated with age, constipation symptom and SAS/SDS scores (P<0.01).2. The total score of health behavior among FC patients was 56.53±15.67. Health behavior was positively correlated with self-efficacy, educational level and the SF-36 total score. However, age, constipation symptom and SAS/SDS scores were negatively related to health behavior(P<0.01). Self-efficacy was the strongest predictor of health behavior, which can explain 67.4% of variance account in health behavior.3. After self-efficacy intervention, self-efficacy and health behavior of FC patients were significantly improved(P<0.01). The score index of patients'compliance was 84.13%, and the compliance score was significantly higher in intervention group than those in historical controls(40.38±4.94 vs 33.17±5.08,P<0.01).4. After self-efficacy intervention, clinical symptom was greatly improved: 50.82%(31/61)of patients were greatly effective, 32.79%(20/61)of patients were effective, the total effective rate was 83.61%, and the total satisfaction of patients was 93.44%.5. After self-efficacy intervention, FC patients improved their quality of life as well as psychological status (P<0.01).Conclusions:Both the level of self-efficacy and health behavior among FC patients were not high, and self-efficacy was the strongest predictor of health behavior. In addition, self-efficacy and health behavior are closely related to psychological status and quality of life among FC patients. Self-efficacy intervention can effectively improve not only the treatment compliance and effective rate but also their health behaviors, and thereby to promote the patients' health.