title: Attitude, social influence, and self-efficacy among Chinese participants of chronic disease self-management program: a latent growth curve modeling study.
abstract: OBJECTIVE
  This study aimed to examine temporal relationships among psychological parameters (readiness to change, changes in self-efficacy [SE], social norm [SN], attitude [AT]) and two self-management behaviors: cognitive symptom management (CSM) and tangible help-seeking (TH) by constructing latent growth change models.
  
  
  METHODS
  This was a longitudinal study of 60 Chinese participants with various chronic diseases who completed a 6-week chronic disease self-management program. Psychological and behavioral variables were assessed at the beginning of the 1st, 4th, and 6th week of the program.
  
  
  RESULTS
  Latent growth change curve analysis revealed that, in the early stages of engagement in CSM, SE was a key determinant of behavior. During the 6-week period, changes in SE were influenced directly by both SN and AT. When engaging in TH, SE influenced the behavior with direct and indirect effect from AT and SN. Readiness for change, on the other hand, appeared to be more associated with psychological rather than behavioral changes. This study revealed different underlying change mechanisms for two types of self-management behaviors.
  
  
  CONCLUSIONS
  The findings shed light on program modifications that could further strengthen the therapeutic effects of the program.
authors.affiliation: Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong, China. rsccchan@inet.polyu.edu.hk
authors.forename: Sam C C
authors.initials: SC
authors.lastname: Chan
authors.forename: Chetwyn C H
authors.initials: CC
authors.lastname: Chan
mesh_terms: D002681:China; D002908:Chronic Disease / Q000534:rehabilitation*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016013:Likelihood Functions; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy