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Self‐efficacy beliefs, faecal incontinence and health‐related quality of life in patients born with anorectal malformations
Author(s) -
Grano C.,
Fernandes M.,
Bucci S.,
Aminoff D.,
Lucidi F.,
Violani C.
Publication year - 2018
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14259
Subject(s) - medicine , fecal incontinence , quality of life (healthcare) , self efficacy , structural equation modeling , distress , affect (linguistics) , mental health , physical therapy , clinical psychology , surgery , psychiatry , psychology , linguistics , statistics , philosophy , nursing , mathematics , psychotherapist
Aim Anorectal malformations ( ARM s) are rare congenital colorectal anomalies with long lasting consequences, among which faecal incontinence is one of the most relevant since it may strongly affect patients’ health‐related quality of life ( HRQ oL). Although a growing body of literature supports the importance of self‐efficacy in chronic disease health outcomes, only few studies have focused on self‐efficacy in ARM s and in faecal incontinence. The purpose of the present study is to examine the mediational role of self‐efficacy in the path between faecal incontinence and HRQ oL in patients born with ARM s. Method Ninety‐eight adult patients from the Italian Association for Anorectal Malformations ( AIMAR ) responded to measures of faecal incontinence, self‐efficacy for managing ARM consequences, and physical and mental HRQ oL ( SF ‐36). Data were analysed by means of structural equation models. Results The tested model provides support for the guiding hypothesis. Fit indices indicate that the model fits the data well (χ 2 = 33.48, df = 23, P = 0.07; comparative fit index [CFI] = 0.97; root mean square error of approximation [RMSEA] = 0.07; standardized root mean square residual [SRMR] = 0.05). Faecal incontinence has negative effects on both physical and mental HRQ oL, as well on self‐efficacy. In turn, self‐efficacy has a positive and direct effect on mental HRQ oL. Conclusion Faecal incontinence is the most relevant and negative factor influencing HRQ oL; in addition, self‐efficacy contributes in reducing emotional distress and in improving mental health outcomes. Longitudinal and controlled studies may be helpful to evaluate the effectiveness of self‐efficacy interventions in improving mental HRQ oL in patients with faecal incontinence.