Self-efficacy and multiple illness representations in older adults: A multilevel approach
Schuez, BEC and Wurm, S and Warner, LM and Ziegelmann, JP, Self-efficacy and multiple illness representations in older adults: A multilevel approach, Psychology and Health: An International Journal, 27, (1) pp. 13-29. ISSN 0887-0446 (2012) [Refereed Article]
Objectives: The Common-Sense Model assumes that individuals form
subjective representations about their illnesses, which in turn guide
cognitive and behavioural responses. This assumption is complicated in
individuals with multimorbidity, and it is an open question to which degree
illness-specific and person-level factors determine the representations of
specific illnesses. This study examines the structure and interrelations of
illness representations in multimorbidity employing a hierarchical framework
based on Cognitive Theory.
Methods: Multiple illness representations were assessed in 305 people aged
65 and older using two Brief Illness Perception Questionnaires. Multilevel
modelling was used to explore the relations between illness representations
and to explain how two illness-specific representations – personal control
and treatment control – were determined by a person-level factor, selfefficacy.
Results: Self-efficacy had significant main (B¼0.29; p50.01 for personal
control; B¼0.19; p50.05 for treatment control) and interaction effects
(B¼0.38; p50.01 personal control on self-efficacytimeline; B¼0.31;
p50.05 treatment control on self-efficacycoherence).
Conclusions: This study suggests that illness-specific representations of
older people with multimorbidity are a product of both illness-specific and
person-level factors, such as self-efficacy. Strengthening individual
self-efficacy may improve illness controllability regardless and on top of