The interplay of self-efficacy and social support as predictors of autonomy in older adults with multimorbidity

Objectives: Multimorbidity - the co-occurrence of multiple illnesses - is a frequent condition in older adults and poses serious threats to autonomy. To investigate ways in which social and personal resources may collude to maintain autonomy despite multimorbidity, the compensation and interference hypotheses were tested.

Methods: 309 individuals with multiple illnesses (age 65+) filled in 3 questionnaires over 6 months assessing self-efficacy beliefs, received instrumental social support and perceptions of autonomy. Two structural equation models were specified predicting autonomy, with and without interaction between self-efficacy and social support.

Results: The model with interaction term had better fit indices and its interaction term was significant (B = 0.30, p < 0.05). Simple slopes analyses showed that social support compensated for low levels of self-efficacy (B = 0.09, p < 0.05), whereas in individuals with high self-efficacy the resources interfered (B = 0.08, p < 0.05).

Conclusions: This interaction with self-efficacy may explain the often emerging negative or non-existent effects of received social support in other studies, as high and low self-efficacious individuals differ in their perception of support as a threat or preservation of autonomy, which should be considered in future interventions.