Factors associated with changes in self-efficacy in patients with systemic lupus erythematosus. Data from the almenara lupus cohort

Aim: To evaluate the factors associated with changes in self-efficacy in systemic lupus erythematosus (SLE) patients from a prevalent cohort. Methods: Members of the Almenara Lupus Cohort who had entered it between 2018 and 2024 were included. Sociodemographic variables were collected. Self-efficacy was examined with the five domains of the PROMIS self-efficacy for the management of chronic conditions’ instrument and general self-efficacy. The Short Form (SF)-36 health questionnaire’ [physical and mental component summary measures (PCS and MCS)] was obtained. Disease activity was ascertained with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), and damage with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Therapeutic variables included the use of antimalarials and of immunosuppressants as well as the daily prednisone dose. Generalized estimating equations were performed using general self-efficacy and the five domains for chronic disease management as outcomes. Results: 331 patients were included; their mean age at diagnosis was 35.1 (SD = 13.7) years and 91.5% their disease duration at baseline was 10.3 (SD = 7.49) years; (n = 303) were women; 97.9% were Mestizo. Factors associated with a better general self-efficacy were White ethnicity (β = 7.09, SE = 1.14, p < 0.001), being currently employed (β = 1.09, SE = 0.53, p = 0.038), PCS (β = 0.08, SE = 0.02, p < 0.001), and previous general self-efficacy (β = 0.39, SE = 0.05, p < 0.001). In contrast, Black ethnicity (β = −2.06, SE = 0.56, p < 0.001 and daily prednisone dose (β = −0.13, SE = 0.02, p < 0.001) were negatively associated with general self-efficacy. Conclusions: Factors associated with general self-efficacy improvement were higher previous self-efficacy, White ethnicity, being currently employed and having a better HRQoL In contrast, Black ethnicity and higher daily prednisone dose predisposed to general self-efficacy worsening.