The effect of adaptation to the disease on the self-efficacy and self-care agency of individuals with chronic heart disease

This descriptive, cross-sectional study investigated the impact of adaptation on self-efficacy and self-care agency in individuals with chronic heart disease. One hundred forty-three patients diagnosed with heart failure and followed at a public hospital participated in the study. Data were collected between 15 January 2024 and 15 June 2024 using a Personal Information Form, the 6-Item Self-Efficacy Scale for Chronic Disease Management, the Chronic Disease Adjustment Scale and the Self-Care Agency Scale. Data analysis was conducted using IBM SPSS v23 and R 4.4.1. Normality was checked with the Kolmogorov-Smirnov test. Pearson or Spearman correlations were applied as appropriate. Robust regression (using the MASS package) was employed for non-normal dependent variables. Robust regression analysis revealed that higher adaptation levels were associated with increased self-efficacy (β = 0.049; p <0.001), accounting for 25.6% of the variance (R² = 0.256). Adaptation also significantly affected self-care agency (β = 1.454; p <0.001), accounting for 67.0% of the variance in scores (R² = 0.670). Physical (β = 0.080; p <0.001) and social adaptation (β = 0.069; p = 0.002) improved self-efficacy, but psychological adjustment did not (β =-0.014; p = 0.615). Combined, these factors explained 28.1% of the variance in self-efficacy (R² = 0.281). Physical (β = 2.200; p <0.001), social (β = 0.775; p = 0.002), and psychological (β = 1.185; p <0.001) adaptation all positively predicted self-care agency, explaining 70.8% of model variance (R² = 0.708). Adaptation to illness significantly boosts both self-efficacy and self-care agency, with a stronger effect on self-care agency. Nursing interventions that promote physical and social adaptation can enhance patient engagement in disease management. Psychological support further improves self-care capacity. Keywords: Chronic heart disease, adaptation to illness, self-efficacy, self-care agency, nursing