SELF-EFFICACY PREDICTS PROMIS HEALTH-RELATED QUALITY OF LIFE OUTCOMES IN TURKISH DIALYSIS PATIENTS BETTER THAN SF-36

 

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https://storage.unitedwebnetwork.com/files/1099/83a2e8c36e08c70ba45544b461be05ed.pdf
SELF-EFFICACY PREDICTS PROMIS HEALTH-RELATED QUALITY OF LIFE OUTCOMES IN TURKISH DIALYSIS PATIENTS BETTER THAN SF-36

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Krister Cromm krister.cromm@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany * Charite Center for Patient-Centered Outcomes Research Berlin Germany
Ngoc Pham Pham ngoc.pham@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany - Charite Center for Patient-Centered Outcomes Research Berlin Germany
Özlem Kuman Tuncel kumanozlem@yahoo.com Ege University School of Medicine Izmir Turkey -
Giovanni Strippoli gfmstrippoli@gmail.com University of Bari Department of Precision and Regenerative Medicine and Ionian Area (Dimepre-J) Bari Italy - University of Sydney School of Public Health Sydney Australia
Tatiana de los Rios tatiana.de-los-rios@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Saynab Atiye saynab.atiye@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Mirja Humpert mc.humpert@arcor.de Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Manuela Stauss-Grabo Manuela.Stauss-Grabo1@freseniusmedicalcare.com Fresenius Medical Care Global Medical Office Bad Homburg Germany -
Gülay Asci gulayas@hotmail.com Ege University School of Medicine Izmir Turkey -
Ercan Ok ercanok61@gmail.com Ege University School of Medicine Izmir Turkey -
Hayriye Elbi hayriye.elbi@yahoo.com Ege University School of Medicine Izmir Turkey -
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Recent research has emphasized the importance of psychosocial factors for health-related quality of life (HRQL) in patients with kidney disease. In particular, self-efficacy (the belief in one’s ability to manage challenges) and social support have been identified as particularly relevant for patient outcomes. As self-efficacy has been shown to be trainable, it may represent a modifiable target for improving HRQL. The purpose of this study was to examine the extent to which self-efficacy and social support predict HRQL among Turkish dialysis patients, beyond demographic and disease-related factors.

Patients receiving either in-center or home hemodialysis in Izmir, Turkey completed electronic surveys assessing HRQL domains, self-efficacy, social support, demographic characteristics and disease impact (burden, symptoms and effects of kidney disease subscales from the KDQOL-36). HRQL was measured using the SF-36 (mental and physical composite scores) and PROMIS (physical and mental health composite scores as well as seven PROMIS-29 domains: fatigue, depression, anxiety, pain intensity, pain interference, physical function, sleep disturbance and ability to participate in social roles and activities). Self-efficacy and social support were assessed using the General Self-Efficacy Scale (GSE) and Medical Outcomes Study Social Support Survey (MOS-SSS) scales. Covariates included demographic characteristics and disease impact. A series of ANCOVA models was employed to analyze the relationship between HRQL scores and domains (dependent variables) and self-efficacy and social support (predictor variables).

The study included 177 patients (mean age 55.5 ± 13.4). Self-efficacy was a significant predictor for mental health (SF-36: F(1,138) = 19.57, p <. 0001, R² = .60; PROMIS: F(1,138) = 5.84, p = 0.02, R² = .47) over and above the covariates. It also predicted PROMIS physical health (F(1,138) = 5.52, p = 0.02; R²=.43) but not SF-36 physical health. Self-efficacy was also a significant predictor for all PROMIS-29 domains except for physical function and pain intensity. Social support was not significantly related to overall HRQL scores. However, the tangible support domain of social support was a significant predictor for sleep disturbance (F (1,138) = 4.27, p = 0.04; R² = .42).

In line with previous research, we show that self-efficacy is a significant predictor for mental health and several HRQL domains in dialysis patients. Given that self-efficacy can be enhanced through behavioral and educational interventions, it represents a practical target for improving patient well-being beyond traditional factors such as age or comorbidities. Compared with the SF-36, PROMIS provided a more sensitive and comprehensive assessment of HRQL, capturing the broader impact of psychosocial factors. Social support, while important in theory, showed limited predictive value in this cohort. 

Kewords