The Relationship between the Self-Efficacy and Treatment Satisfaction to Anticoagulant Therapy: A Cross-Sectional Study Among Palestinian Patients in Jerusalem

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Abu Dalu, Amal
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An Najah National University
Background: Thromboembolic events are a common complicated health problem. Although anticoagulants have several positive effects on these conditions, they also have several characteristics that can strongly affect compliance and satisfaction, inducing dissatisfaction and reducing the patient’s quality of life; patient’s self-efficacy and satisfaction can increase compliance and result in treatment success. Objectives: This study aims to assess the association between treatment satisfaction and self-efficacy in a sample of patients from Palestine using anticoagulation therapy, and to determine the influence of socio-demographic and clinical factors on both aspects. Methods: This was a cross-sectional study performed in Palestine. The Arabic version of the Anti-Coagulant Treatment satisfaction scale (ACTS) scale was used to assess treatment satisfaction. The Arabic version of Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G) was used to assess self-efficacy. Results: A total of 300 patients using anticoagulants (average age 51.95 and SD of 17.98) were included. There is a weak correlation between total score, treatment satisfaction domain and self-efficacy (r = 0.35; p = 0.00). Overall, the patients reported a moderate burden and benefit score; the mean and median of the acting burden were 43.30±10.45, and 43.30 (interquartile range: 36–51). The mean and median self-efficacy score were 38.41±9.88, and 39 (interquartile range: 33–46). The results showed that those how were younger (44.32±9.09, p<0.001), more highly educated (40.65±9.9, p<0.001), were employed (40.04±10.26, p=0.049), with a lower number of medications (39.32±9.95, p=0.029) and lower number of diseases (40.3±10.56, p=0.34) had a good predictor of self-efficacy behaviors. They also showed that males (45.01±9.88, p=0.006), married (44.29±10.26, p=0.005), and with higher monthly income (46.06±11.10, p=0.001) had a higher ACTS burden score. In contrast, young (14.55±0.89, p=<0.001), married (12.01±2.14, p=0.003) female (12.07±2.26, p=0.015), normal weight (12.63±2.08, p=0.003), higher educational level (12.38±2.15, p<0.001) participants had a higher ACTS benefit score. Results also showed that new oral anticoagulants (NOACs) had a higher degree of self-efficacy and ACTS benefit scores (39.00±8.20, p=0.002; 13.07±1.89, p=0.001), respectively, than vitamin k antagonists (VKA). Conclusions: Overall, these results found that there is a relation between treatment satisfaction and self-efficacy, and socio-demographic and clinical characteristics probably influence both. We found that there is a higher degree of self-efficacy and treatment satisfaction among patients using NOACs than those who used UFH/VKA. We also found an association between higher education, young, unemployed patients with a lower number of diseases and medications, and a good level of self-efficacy. In addition, we found an association between being female, unmarried, have a low monthly income were more burdened, while young, male, unmarried, normal weight, higher educated, and having a lower number of diseases and medications, had a higher level of benefits scoring.
Thromboembolic , socio-demographic , anticoagulation