Physical, Psychological, Social Support, Adherence, and Educational Factors Associated With Self-Efficacy in Rheumatoid Arthritis: Scoping Review
Carla Moreira Lorentz Higa, Aline Moraes da Silva, Jhoniffer Lucas das Neves Matricardi, Andréia Insabralde de Queiroz Cardoso, Paula Felippe MartinezBackground:
Rheumatoid arthritis is a disease whose treatment requires patient commitment to control disease activity, which is directly related to self-efficacy. The objective of this study was to map physical, psychological, social support, treatment adherence, and educational program variables associated with self-efficacy, as measured by validated RA-specific instruments.
Methods:
This scoping review followed a comprehensive search of major biomedical databases and gray literature. Inclusion criteria were full-text articles, theses, and dissertations published from 1977 onwards, in English, Spanish, or Portuguese. The search identified 4737 records, of which 43 studies met the criteria and were included in the final sample.
Results:
The studies originated from 5 continents and were published in English and Spanish, exhibiting heterogeneous characteristics. All used quantitative methods, with the majority being cross-sectional (44.19%, n=19), followed by randomized clinical trials (39.53%, n=17). Most participants were female (76.60%, n=5580), with a mean age of 55.90 years. The results were categorized into 3 areas: positive, negative, and nonsignificant associations. Treatment adherence, positive psychological factors, and social support were positively associated with self-efficacy, whereas physical factors and negative psychological factors showed negative associations. In the education and self-management group, 10 educational and self-management programs showed a positive association with self-efficacy. In contrast, 4 other programs showed no significant association.
Conclusions:
Although the results do not fully reflect causal relationships, they suggest the importance of addressing the psychological, physical, treatment adherence, and social support factors in individuals with rheumatoid arthritis, as well as promoting educational and self-management measures to increase self-efficacy.