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Purpose <p>Informal caregivers play a critical role in supporting Self-Care behaviors in patients with inflammatory bowel disease (IBD). However, the extent to which caregiver burden, health literacy, and Self-Efficacy predict their contribution to patient Self-Care remains unclear, and the potential mediating role of Self-Efficacy has not yet been established.</p> Methods <p>A multicenter cross-sectional study was conducted across nine Italian IBD centers. Caregivers completed validated instruments assessing burden (Zarit Burden Interview, score range 0–88; higher scores indicate greater burden), health literacy (Single Item Literacy Screener, 1–5; scores &gt; 2 indicate inadequate literacy), Self-Efficacy (CSE-CSC, standardized 0–100; higher scores indicate greater confidence), and caregiver contribution to Self-Care (CC-SC-CII, standardized 0–100 across maintenance, monitoring, and management; higher scores indicate greater contribution). Structural equation modelling explored direct and indirect associations among study variables.</p> Results <p>Among 275 caregivers, the mean age was 51&#xa0;years (<i>SD</i> = 13); 160 (58%) were female and 115 (42%) male. Mean contribution scores were 54.99 (<i>SD</i> = 25.62) for Self-Care Maintenance, 67.33 (<i>SD</i> = 32.28) for Self-Care Monitoring, and 56.18 (<i>SD</i> = 23.15) for Self-Care Management. Mean Self-Efficacy was 72.41 (<i>SD</i> = 18.42). Self-Efficacy significantly predicted Self-Care Monitoring&#xa0; (<i>β</i> = 0.34, <i>p</i> &lt; 0.001) and Self-Care Management (<i>β</i> = 0.42, <i>p</i> &lt; 0.001), while burden showed modest but significant associations across domains. Health literacy demonstrated no significant effects, and no mediation pathways were identified.</p> Conclusion <p>Self-Efficacy emerged as a central determinant of caregiver contribution to patient Self-Care in IBD, particularly for Self-Care Monitoring&#xa0; and Self-Care Management&#xa0; behaviors. Interventions aimed at strengthening caregiver confidence and tailored to gender- and disease-specific needs may enhance the quality of caregiving and ultimately support better patient outcomes.</p>

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Self-Efficacy as a Mediator Between Caregiver Burden, Health Literacy, and Contribution to Self-Care in Inflammatory Bowel Disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月3日

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  • Daniele Napolitano,
  • Mattia Bozzetti,
  • Francesco Petrosino,
  • Silvia Cilluffo,
  • Francesca Trotta,
  • Gianluca Pucciarelli,
  • Davide Bartoli,
  • Alessio Lo Cascio,
  • Ercole Vellone

摘要

Purpose

Informal caregivers play a critical role in supporting Self-Care behaviors in patients with inflammatory bowel disease (IBD). However, the extent to which caregiver burden, health literacy, and Self-Efficacy predict their contribution to patient Self-Care remains unclear, and the potential mediating role of Self-Efficacy has not yet been established.

Methods

A multicenter cross-sectional study was conducted across nine Italian IBD centers. Caregivers completed validated instruments assessing burden (Zarit Burden Interview, score range 0–88; higher scores indicate greater burden), health literacy (Single Item Literacy Screener, 1–5; scores > 2 indicate inadequate literacy), Self-Efficacy (CSE-CSC, standardized 0–100; higher scores indicate greater confidence), and caregiver contribution to Self-Care (CC-SC-CII, standardized 0–100 across maintenance, monitoring, and management; higher scores indicate greater contribution). Structural equation modelling explored direct and indirect associations among study variables.

Results

Among 275 caregivers, the mean age was 51 years (SD = 13); 160 (58%) were female and 115 (42%) male. Mean contribution scores were 54.99 (SD = 25.62) for Self-Care Maintenance, 67.33 (SD = 32.28) for Self-Care Monitoring, and 56.18 (SD = 23.15) for Self-Care Management. Mean Self-Efficacy was 72.41 (SD = 18.42). Self-Efficacy significantly predicted Self-Care Monitoring  (β = 0.34, p < 0.001) and Self-Care Management (β = 0.42, p < 0.001), while burden showed modest but significant associations across domains. Health literacy demonstrated no significant effects, and no mediation pathways were identified.

Conclusion

Self-Efficacy emerged as a central determinant of caregiver contribution to patient Self-Care in IBD, particularly for Self-Care Monitoring  and Self-Care Management  behaviors. Interventions aimed at strengthening caregiver confidence and tailored to gender- and disease-specific needs may enhance the quality of caregiving and ultimately support better patient outcomes.