title: The role of self-efficacy in vascular risk factor management: a randomized controlled trial.
abstract: OBJECTIVE
  Given the large number of patients at high risk of vascular events, new strategies are needed to reduce vascular risk. We investigated whether self-efficacy promotion could change self-efficacy levels in patients with vascular diseases and whether baseline self-efficacy and changes in self-efficacy were related to changes in vascular risk factors.
  
  
  METHODS
  One hundred fifty-three recently referred patients with symptomatic vascular diseases (cerebrovascular, abdominal, or peripheral arterial) participated in a randomized trial investigating the effect of nursing care, as compared with usual care, on vascular risk factors. Nursing care consisted of self-efficacy promotion and medical treatment of vascular risk factors. Self-efficacy and vascular risk factors (smoking, BMI, waist, blood pressure, lipid, and glucose levels) were measured at baseline and after 1 year.
  
  
  RESULTS
  While total self-efficacy did not change over the 1-year intervention period in either treatment group, self-efficacy in choosing healthy food (mean +0.4+/-1.4, p-value 0.01) and in doing extra exercise (mean +0.3+/-1.3, p-value 0.03) increased in the intervention group. No relation was seen between baseline total self-efficacy or change in composite self-efficacy and change in vascular risk factors.
  
  
  CONCLUSIONS
  The nursing intervention did not influence total self-efficacy but did improve self-efficacy in choosing healthy food and doing extra exercise. Change in composite self-efficacy was not related to change in vascular risk factors in patients at high risk of developing (new) cardiovascular diseases.
  
  
  CONCLUSIONS
  Influencing self-efficacy in choosing healthy food and doing extra exercise could be incorporated in vascular risk reduction programs in addition to medical treatment of vascular risk factors.
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht, The Netherlands. B.Sol@umcutrecht.nl
authors.forename: Berna G M
authors.initials: BG
authors.lastname: Sol
authors.forename: Yolanda
authors.initials: Y
authors.lastname: van der Graaf
authors.forename: Jaap J
authors.initials: JJ
authors.lastname: van der Bijl
authors.forename: Bertine M B
authors.initials: BM
authors.lastname: Goessens
authors.forename: Frank L J
authors.initials: FL
authors.lastname: Visseren
mesh_terms: D003920:Diabetes Mellitus / Q000517:prevention & control; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control; D006973:Hypertension / Q000517:prevention & control; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D009765:Obesity / Q000517:prevention & control; D010353:Patient Education as Topic; D010358:Patient Participation; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012648:Self Care / Q000379:methods / Q000523:psychology; D020377:Self Efficacy; D000074606:Smoking Prevention; D014652:Vascular Diseases / Q000209:etiology / Q000517:prevention & control*