Self-Efficacy and Social Support in African Americans Diagnosed with End Stage Renal Disease

Article excerpt

Abstract: The purpose of this descriptive study was to measure levels of self-efficacy and social support beliefs in African Americans diagnosed with End Stage Renal Disease (ESRD). Eighty-five African Americans, age 20 to 86 years old, participated in the study. Forty were males and 45 were females. The General Self-Efficacy Scale was used to determine the overall self-efficacy level of the participants, and the Personal Resource Questionnaire was used to assess perceived social support One sample t-tests revealed that self-efficacy and social support levels were high in African Americans with ESRD. High levels of self-efficacy and social support have the potential to improve health outcomes.

Key Words: Self-Efficacy, Social Support, African American, End Stage Renal Disease, Hemodialysis

End Stage Renal Disease (ESRD) is a chronic illness that is very debilitating. Individuals with this disease are faced with having life sustaining hemodialysis treatments that are generally scheduled three times a week, lasting from 3 to 5 hours each session. A large proportion of people affected by this disease have limited lives as a result of the time constraints of treatments. In 2007, over 500,000 Americans received ESRD treatment (United States Renal Data System [USRDS], 2010a), with African Americans having an incidence of ESRD 3.7 times higher than that of Caucasians (USRDS, 2010b). In addition to many other chronic illnesses, African Americans are disproportionately affected by ESRD (National Kidney Foundation, 2010) as well. Thus, African Americans have significant disparities in health outcomes related to ESRD.

Self-management of chronic illnesses, such as ESRD, can be influenced by various biological, behavioral, and social factors which can influence health and adherence (Kammerer, Garry, Hartigan, Carter, & Erlich, 2007). There is a need to explore these factors. The literature has consistently identified self-efficacy and social support as modifiable risk factors that can impact and improve medical adherence and health outcomes (Cohen, Sharma, Acquaviva, Peterson, Patel, & Kimmel, 2007; Hopkins, 2005; Klang, Bjorvell, Berglund, Sundstedt, & Clyne, 1998; Lev & Owen, 1998; Luszczynska, Mohamed & Schwarzer, 2005; Plantinga et al., 2010; Takaki & Yano, 2006).

A belief in one's self-efficacy enhances or limits motivation by influencing the types of goals that individuals set for themselves, the extent of effort they expend, and thenpersistence in the face of difficulties (Gredler, 2005). People tend to avoid activities they feel are beyond their coping capabilities (Bandura, 1995). If one does not believe that their actions will produce a positive outcome, there is little motivation to continue. Self-efficacy beliefs have the potential to improve health outcomes as well as decrease health status.

Social support plays a key role in positive health outcomes. It includes resources offering emotional comfort, physical assistance, and solutions to problems in order to preserve a patient's sense of self-esteem and self-competency (Given & Given, 1989). According to Aday (2001), physical, psychological, and social well-being are directly enhanced for people who have supportive social networks. Those diagnosed with ESRD have many constraints related to their illness that they need strong and positive social ties to overcome them. The purpose of this study was to measure levels of self-efficacy and social support beliefs in African Americans diagnosed with ESRD who were undergoing hemodialysis.

BACKGROUND

Self-Efficacy

Several studies have shown that self-efficacy beliefs influence aspects of care related to patients with ESRD. Self-efficacy beliefs have been shown to influence personal growth, acceptance of life's imperfections, sensitivity to others (Luszcynska et al., 2005), health locus of control (Takaki & Yano, 2006), self care behaviors (Wu, Courtney, Edwards, McDowell, Shortridge-Baggett, & Chang, 2007), and fluid adherence (Tsay, 2003; Yokoyama et al. …