title: Health risk appraisal for older people 5: self-efficacy in patient-doctor interactions.
abstract: OBJECTIVE
  Enhancing self-efficacy is central to programmes promoting self-care and self-management. However, little is known about older people's self-efficacy in doctor-patient interactions. This paper investigates lifestyle, medical and demographic factors associated with self-efficacy in doctor-patient interactions in older people in general practice.
  
  
  METHODS
  A cross-sectional analysis of data from a randomised controlled trial of older people was conducted in a health risk appraisal study in London. Self-efficacy was measured using the Perceived Efficacy in Patient-Physician Interactions Questionnaire.
  
  
  RESULTS
  Older people with higher self-efficacy were significantly more likely to report having had recent preventive care measures such as recent blood pressure measurement and influenza immunisation. Women were less likely to have higher self-efficacy than men. Older people were significantly less likely to have high self-efficacy if they reported having poor memory, low mood, limited activities due to fear of falling, basic education, difficulties with at least one activity of daily living, reduced physical activity, living alone, or risk of social isolation.
  
  
  CONCLUSIONS
  A third of people had low self-efficacy in doctor-patient interactions. They appear to be a vulnerable group. Low self-efficacy in interactions with doctors may be a symptom or a characteristic of older people who experience social isolation and depression. Policies that depend on enhancing self-care and self-management need to consider the large number of older people with low self-efficacy in using medical services, and understanding characteristics in older people associated with lower confidence in doctor-patient interactions may be useful in clinical practice and research.
authors.affiliation: Department of Primary Care and Population Sciences, University College London, Hampstead Campus, London, UK. mareeni_R@yahoo.com
authors.forename: Mareeni
authors.initials: M
authors.lastname: Raymond
authors.forename: Steve
authors.initials: S
authors.lastname: Iliffe
authors.forename: Kalpa
authors.initials: K
authors.lastname: Kharicha
authors.forename: Danielle
authors.initials: D
authors.lastname: Harari
authors.forename: Cameron
authors.initials: C
authors.lastname: Swift
authors.forename: Gerhard
authors.initials: G
authors.lastname: Gillmann
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Stuck
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011315:Preventive Medicine; D011320:Primary Health Care / Q000379:methods; D018570:Risk Assessment / Q000379:methods*; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires