Self-care and self-efficacy in self-care behaviors of older adults with multiple chronic conditions living in low-middle income country: an observational study

Abstract

Background: Multiple chronic conditions (MCCs) are highly prevalent worldwide, particularly among adult patients living in low- and middle-income countries (LMICs). Self-care behaviors are recommended to reduce the burden of MCCs and improve outcomes. Self-care is a naturalistic decision-making process that encompasses maintenance, monitoring, and management of chronic conditions. Self-efficacy in self-care, defined as an individual’s confidence in performing effective self-care behaviors, is essential for sustaining long-term behavioral change. However, evidence on self-care and self-efficacy in self-care behaviors among older adults with MCCs in LMICs remains limited. This study aimed to describe self-care and self-efficacy in self-care behaviors among older adults with MCCs living in Albania, an LMIC. Design: Multicenter cross-sectional observational study. Methods: We recruited patients affected by MCCs living in Albania, an LMIC. The Self-Care of Chronic Illness Inventory (SC-CII) and the Self-Care Self-Efficacy Scale (SC-SES) were used to assess self-care and self-efficacy in self-care behaviors, respectively. Descriptive statistics were carried out. Results: A sample of 376 patients were enrolled. Participants were mostly female (54.3%), with a mean age of 74.1 (SD = 6.2) years, low educational level (65.4%). On average, participants had two chronic conditions. The most frequently reported conditions were hypertension (88.2%) and diabetes mellitus (DM) (75.1%). The least frequently performed self-care behaviors included engaging in regular physical activity (63%), practicing stress management (85%), monitoring medication side effects (41.5%), and adjusting diet or fluid intake in response to symptoms (60%). Conclusion: Older adults with MCCs living in Albania, a representative of LMIC reported inadequate self-care and self-efficacy in self-care in specific behaviors. These findings highlight the urgent need for tailored interventions to enhance self-care and self-efficacy in self-care behaviors in this vulnerable population. Further research is needed to identify factors influencing self-care behaviors among older adults with MCCs in LMICs. Clinical trial number: Not applicable.