Study On General Self-Efficacy Of Elderly With Multimorbidity In Shandong Province

Background:With the acceleration of population aging,chronic diseases seriously threaten human health.Multimorbidity has become the normal state of the elderly in China.The health of elderly patients with multimorbidity is threatened and they are suffering from a long series of illnesses,their psychological conditions may change significantly.A high sense of general self-efficacy can improve the individual's control of the environment,improve the health management ability of patients with chronic diseases,increase their confidence in facing diseases,improve treatment compliance and health outcomes,thereby promoting physical and psychological health.As a province with a large population of elderly people,the phenomenon of multimorbidity is obvious in Shandong.The general self-efficacy of elderly patients with multimorbidity deserves attention.Objectives:The aim of this study is to understand the general self-efficacy status of elderly patients with multimorbidity in Shandong Province,explore its potential classification,analyze the impact of sociodemographic characteristics,economic status,health and psychological status,social support status,lifestyle on general self-efficacy,and provide suggestions to improve their general self-efficacy.Methods:This study was derived from database of the National Natural Science Foundation of China(71673169).Multi-stage stratified random sampling was used to select samples.A total of 7070 elderly people were surveyed.In this study,2333 elderly patients with multimorbidity were selected as the research object.The survey included relevant information such as the sociodemographic characteristics,economic status,health and psychological status,social support status,lifestyle,and general self-efficacy of the surveyed subjects.Epidata 3.0 software was used to enter the database,M plus 7.0 was used to build a latent category model,and SPSS 24.0 was used for chi-square test and multiple logistic regression.The test level was bilateral probability,and P<0.05 was considered statistically significant.Results:The average general self-efficacy score of elderly with multimorbidity was 26.21±8.33.The general self-efficacy status of elderly with multimorbidity can be divided into three categories according to the latent category analysis(P<0.05):"High general self-efficacy group(C1)","Medium general self-efficacy group of accident evasion(C2)","low general self-efficacy group(C3)",the numbers accounted for 48.91%,22.89%,and 28.20%,respectively.The results showed that compared with the C3 group,in C1 group,the elderly with multimorbidity that who were 60-69 years old(OR=1.526,1.527,respectively,both P<0.05),retired(leaving)off(OR=2.018,P<0.05),good and general self-reported health(OR=2.273,1.318,respectively,both P<0.05),normal daily activities and decreased function(OR=2.842,1.843,respectively,both P<0.05),good medication compliance(OR=1.421,P<0.05),good,average,and poor mental condition(OR=4.503,3.459,2.422,respectively,all P<0.05),extroverted elderly(OR=l.756,P<0.05)generally had a higher sense of general self-efficacy.Illiteracy(OR=0.529,P<0.05),who had no spouse(OR=0.661,P<0.05),and those didn't have intimate friends(OR=0.568,P<0.05)had lower general self-efficacy.Compared with C3 group,in C2 group,the elderly with multimorbidity that who were retired(leaving)off(OR=1.886,P<0.05),had savings(OR=1.525,P<0.05),good and general self-reported health(OR=1.564,1.364,respectively,P<0.05),had normal daily activities ability and decreased function(OR=2.481,2.183,respectively,both P<0.05),good,average,and poor mental condition(OR=2.568,3.090,2.202,respectively,P<0.05)elderly patients with multimorbidity generally had a higher sense of general self-efficacy,patients with high life stress(OR=0.638,P<0.05),and who didn't often communicate with their children(OR=0.711,P<0.05)had lower general self-efficacy.Conclusions and suggestions:The general self-efficacy level of elderly patients with multimorbidity was relatively low.According to the analysis of potential categories,it can be divided into 3 categories,of which nearly half of elderly patients were in the high general self-efficacy group.Each category differed in age,education level,marital status,work status,whether or not to save,self-reported health status,activities of daily living,medication compliance,mental health status,personality,life stress,communication with children and whether have intimate friends.It is necessary to establish and improve the health service system for the elderly,pay attention to the vulnerable groups of multimorbidity elderly with no job,poverty,poor health status and self-care ability.And it's also necessary to improve the endowment insurance and medical insurance systems,strengthen the provision of elderly care services,and construct a social environment that respects,loves,and honors the elderly.Local communities should actively carry out flexible and diverse health education activities based on the characteristics of elderly patients with multimorbidity,help patients learn disease-related knowledge,carry out self-care and management with a healthy and positive attitude,exert the general self-efficacy to promote the physical and mental health of elderly patients with multimorbidity.A social support network for benign interaction between society and family should be established to encourage elderly patients to socialize actively,and to create a supportive living environment for elderly.Elderly patients with multimorbidity should face their own physical and psychological characteristics,actively participate in society,establish a healthy and upward attitude to life,and enhance their sense of value and general self-efficacy.