THE INFLUENCE OF FAMILY FUNCTIONING ON MEDICAL SELF-EFFICACY IN ADOLESCENTS WITH SICKLE CELL DISEASE

Abstract

Objectives: Medical self-efficacy is defined as an individual’s belief in his or her ability to manage aspects of their disease and to lead to desired health outcomes (Edwards, Telfair, Cecil, and Lenoci, 2001). Prior research has related high medical self-efficacy with positive health outcomes in adolescents and adults with sickle cell disease (SCD; Clay and Telfair, 2007; Edwards et al, 2001). There has been a limited amount of research examining factors related to the promotion of medical self-efficacy in youth with SCD. The purpose of the current study is to investigate the influence of family functioning on medical self-efficacy in adolescents with SCD.

Methods: Fifty adolescents (29 females, 21 males) with SCD, aged 12 to 17 (M=14.68 ± 1.56 years), and their guardians were interviewed for inclusion in a larger study investigating the relationship between sleep and pain in youth with SCD. All participants in the study were required to have experienced SCD-related pain within the past year. Guardians of the adolescents reported on the adolescents’ age, sex, and SCD genotype. They also completed the Structured Pain Interview for Parents to assess adolescents’ SCD-related pain frequency in the past year and the Family Environment Scale to assess family functioning. Adolescents were asked to complete the Sickle Cell Self-Efficacy Scale to measure their level of medical self-efficacy. Correlation coefficients and a multiple regression were calculated to examine the relationship between medical self-efficacy and family cohesion, expressiveness, conflict, and independence promotion.

Results: Correlation coefficients indicated that medical self-efficacy was not related to family cohesion (r=.19, p=.19), expressiveness (r=.26, p=0.07), conflict (r=0.09, p=.51), or independence promotion (r=.14, p=.32). The model predicting self-efficacy using the family functioning factors was also not significant (F=0.65, p=0.68).

Conclusions: These findings suggest that family functioning is not related medical self-efficacy in adolescents with SCD. More research is needed to identify what factors are related to the development of medical self-efficacy in adolescents with SCD. This will aid in the development of programs to promote medical self-efficacy and long term health outcomes for this population.