DOI: https://doi.org/10.14710/nmjn.v12i1.32938

The Relationship between Self-Efficacy, Self-Care Behavior, and Generalized Anxiety Disorder in COVID-19: A Path Analysis Model

Mohammad Hossien Delshad orcid scopus  -  Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Iran, Islamic Republic of
Fahimeh Pourhaji  -  PhD candidate, Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Iran, Islamic Republic of
*Fatemeh Pourhaji orcid  -  Department of Public Health, School of Health, Torbat Heydariyeh University of Medical Sciences, Iran, Islamic Republic of
Hassan Azhdari Zarmehri  -  Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Iran, Islamic Republic of
Open Access Copyright (c) 2022 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: The outbreak of the COVID-19 pandemic has a strong impact on individuals and becomes a very stressful period. Long-term exposure to stress due to lockdown scenario may also increase psychological distress by reducing support resources, and in these circumstances, personal resources such as self-efficacy and its relationships appear important. It is important to explore people’s beliefs about their capabilities to produce designated levels of behavior in the face of COVID-19, which is not known in the target population, and also to show its effect on anxiety.

Purpose: This study aimed to investigate the relationship between self-efficacy, self-care behavior, and generalized anxiety disorder in COVID-19.

Methods: A cross-sectional online survey was performed after COVID-19 was confirmed in Iran. The samples of the study were 500 residents in the Razavi Khorasan province, Iran, that were randomly selected. Demographic data, general self-efficacy, self-care behavior, and the Generalized Anxiety Disorder (GAD-7) questionnaires were used for data collection. The data were analyzed using bivariate correlation and hierarchical linear regression models.

Results: The mean(SD) age of the participants was 31.9(11.9). Their GAD-7 scores had severe anxiety (score ≥17). There was a negative and significant relationship between generalized anxiety disorder and self-efficacy (r=-0.238, p≤0.01). Also, there was a positive and significant relationship between self-efficacy and self-care behavior. No significant relationship between generalized anxiety disorder and self-care behavior was found. The path analysis model estimated anxiety and self-efficacy as about 4% of the variance self-care behavior in COVID-19.

Conclusion: This study revealed that enhancing self-efficacy levels might reduce anxiety. Self-efficacy-enhancing programs should be used as part of the routine readiness effort drives and health care system change.
Fulltext View|Download
Keywords: Anxiety disorder; corona disease; self-care behavior; self-efficacy

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
Coronaphobia and Coping among the Bereaved: The Mediating Role of Gardening during the Covid-19 Pandemic The Relationship between Self-Efficacy, Self-Care Behavior, and Generalized Anxiety Disorder in COVID-19: A Path Analysis Model The Role of Organizational Culture in Moderating Effect of Emotional Labor Strategies on Nursing Professionalism Editorial Back Matter Editorial Front Matter More recent articles
Most cited articles
Correlates of Physical Activity in Asian Adolescents: A Literature Review A Review of the Quality Improvement in Discharge Planning through Coaching in Nursing Review: Burden on Family Caregivers Caring for Patients with Schizophrenia and Its Related Factors Mental Distress in Rural Areas of Indonesia The Lived Experiences of the Lombok Earthquake Survivors More cited articles
  1. Abdi, R., Bakhshi, A., & Mahmoud, A. M. (2013). Efficacy of unified transdiagnostic treatment on reduction of transdiagnostic factors and symptoms severity in emotional disorders. Journal of Psychological Models and Methods, 3(13),1-27
  2. Asadi, M., Kiani, A., Azimi, L., & Gharibi, Z. (2021). COVID-19 related anxiety and self-care behaviors in students based on demographic characteristics: A cross-sectional study. Journal of Clinical Psychology, 13(2), 169-80
  3. Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173. https://doi.org/10.1037//0022-3514.51.6.1173
  4. Bihlmaier, I., & Schlarb, A. A. (2016). Self-efficacy and sleep problems. Somnologie, 20(4), 275-280. https://doi.org/10.1007/s11818-016-0085-1
  5. Bowsher, J. E., & Keep, D. (1995). Toward an understanding of three control constructs: Personal control, self-efficacy, and hardiness. Issues in Mental Health Nursing, 16(1), 33-50. https://doi.org/10.3109/01612849509042961
  6. Cacioppo, J. T., & Cacioppo, S. (2018). The growing problem of loneliness. The Lancet, 391(10119), 426. https://doi.org/10.1016/S0140-6736(18)30142-9
  7. Du, J., Dong, L., Wang, T., Yuan, C., Fu, R., Zhang, L., Qin, J. (2020). Psychological symptoms among frontline healthcare workers during COVID-19 outbreak in Wuhan. General Hospital Psychiatry, 67(1), 144-145. https://doi.org/10.1016/j.genhosppsych.2020.03.011
  8. Heo, S., Moser, D. K., Lennie, T. A., Riegel, B., & Chung, M. L. (2008). Gender differences in and factors related to self-care behaviors: A cross-sectional, correlational study of patients with heart failure. International Journal of Nursing Studies, 45(12), 1807-1815. https://doi.org/10.1016/j.ijnurstu.2008.05.008
  9. Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 epidemic in China: A web-based cross-sectional survey. Psychiatry Research, 288(1),112954. https://doi.org/10.1016/j.psychres.2020.112954
  10. Kwok, K. O., Li, K. K., Chan, H. H., Yi, Y. Y., Tang, A., Wei, W. I., & Wong, Y. S. (2020). Community responses during the early phase of the COVID-19 epidemic in Hong Kong: Risk perception, information exposure and preventive measures. Emerging Infectious Diseases, 26(7), 1575-1579. https://doi.org/10.3201/eid2607.200500
  11. Lau, J. T. F., Griffiths, S., Choi, K. C., & Tsui, H. Y. (2010). Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infectious Diseases, 10(1), 139. https://doi.org/10.1186/1471-2334-10-139
  12. Lee, S. A. (2020). Coronavirus anxiety scale: A brief mental health screener for COVID-19 related anxiety. Death Studies, 44(7), 393-401. https://doi.org/10.1080/07481187.2020.1748481
  13. Losada-Baltar, A., Jiménez-Gonzalo, L., Gallego-Alberto, L., Pedroso-Chaparro, M. D. S., Fernandes-Pires, J., & Márquez-González, M. (2020). “We’re staying at home”. Association of self-perceptions of aging, personal and family resources and loneliness with psychological distress during the lock-down period of COVID-19. The Journals of Gerontology: Series B, 76(2), e10-e16. https://doi.org/10.1093/geronb/gbaa048
  14. Mahmoud, A. M., Hashemi, N. T., & Sohrabi, F. (2016). Effectiveness of combined intervention based acceptance and commitment therapy (ACT) with exposure techniques on patient's anxiety symptoms intensity and sensitivity dimensions in general anxiety disorder (GAD). Journal of Clinical Psychology, 8(3), 61-76
  15. Mailani, F., Huriani, E., Muthia, R., & Sarfika, R. (2021). Nurses’ intention to work during the COVID-19 outbreak in West Sumatra, Indonesia. Nurse Media Journal of Nursing, 11(1), 50-60. https://doi.org/10.14710/nmjn.v11i1.34093
  16. Martin, L. B. (2009). Stress and immunity in wild vertebrates: Timing is everything. General and Comparative Endocrinology, 163(1), 70-76. https://doi.org/10.1016/j.ygcen.2009.03.008
  17. Mohammadpour, M., Ghorbani, V., Khoramnia, S., Ahmadi, S. M., Ghvami, M., & Maleki, M. (2020). Anxiety, self-compassion, gender differences and COVID-19: Predicting self-care behaviors and fear of COVID-19 based on anxiety and self-compassion with an emphasis on gender differences. Iranian Journal of Psychiatry, 15(3), 213-219. https://doi.org/10.18502/ijps.v15i3.3813
  18. Mousavi, S. H., Delshad, M. H., Acuti Martellucci, C., Bhandari, D., Ozaki, A., & Pourhaji, F., Pourhaji, F., Hosseini, S. M. R., Roien, R., Ramozi, A. A., Wafaee, M., Qaderi, S., Delsoz, M., Sigdel, S., Kotera, Y., Sawano, T., Dhama, K., Rodríguez-Morales, A. J., Wang, J., … Sah, R. et al. (2021). Community behavioral and perceived responses in the COVID-19 outbreak in Afghanistan: A cross-sectional study. Disaster Medicine and Public Health Preparedness, 5(1), 1-7
  19. Mukhtar, S. (2020). Mental health and emotional impact of COVID-19: Applying health belief model for medical staff to general public of Pakistan. Brain, Behavior, and Immunity, 87, 28–29. https://doi.org/10.1016/j.bbi.2020.04.012
  20. Muris, P. (2002). Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Personality and Individual Differences, 32(2), 337-348
  21. Naeinian, M. R., Shaeiri, M. R., Sharif, M., & Hadian, M. (2011). To study reliability and validity for a brief measure for assessing Generalized Anxiety Disorder (GAD-7). Clinical Psychology & Personality, 9(1), 41-50
  22. Pourhaji F., Pourhaji F., Tehrani H., Talebi M., & Peyman N.( 2022). Perceived threat and stress responses in the face of Covid-19 based on health belief model. Journal of Health Literacy, 7(1), 17-25
  23. Polit, D. F., Beck, C. T., & Owen, S. V. (2007). Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health, 30(4), 459-467. https://doi.org/10.1002/nur.20199
  24. Pragholapati, A. (2020). Self-efficacy of nurses during the pandemic Covid-19. https://www.academia.edu/43045687/Self_Efficacy_Of_Nurses_During_The_Pandemic_Covid_19
  25. Przepiórka, A., Błachnio, A., & Siu, N. Y. F. (2019). The relationships between self-efficacy, self-control, chronotype, procrastination and sleep problems in young adults. Chronobiology International, 36(8), 1025-1035. https://doi.org/10.1080/07420528.2019.1607370
  26. Qian, M., Wu, Q., Wu, P., Hou, Z., Liang, Y., Cowling, B. J., & Yu, H. (2020). Psychological responses, behavioral changes and public perceptions during the early phase of the COVID-19 outbreak in China: A population based cross-sectional survey. BMJ Open, 10(10), e040910. https://doi.org/10.1136/bmjopen-2020-040910
  27. Sharma, M. (2016). Theoretical foundations of health education and health promotion. Jones & Bartlett Publishers
  28. Simonetti, V., Durante, A., Ambrosca, R., Arcadi, P., Graziano, G., Pucciarelli, G., & Cicolini, G. (2021). Anxiety, sleep disorders and self‐efficacy among nurses during COVID‐19 pandemic: A cross‐sectional study. Journal of Clinical Nursing, 30(9-10), 1360-1371. https://doi.org/10.1111/jocn.15685
  29. Spitzer, R., Kroenke , K., Williams, J., & Bernd , L. (2006). A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092-1097. https://doi.org/10.1001/archinte.166.10.1092
  30. Tahmassian, K., & Jalali Moghadam, N. (2011). Relationship between self-efficacy and symptoms of anxiety, depression, worry and social avoidance in a normal sample of students. Iranian Journal of Psychiatry and Behavioral Sciences, 5(2), 91-98
  31. Tharek, Z., Ramli, A. S., Whitford, D. L., Ismail, Z., Zulkifli, M. M., Sharoni, S. K. A., Jayaraman, T. (2018). Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Family Practice, 19(1), 1-10. https://doi.org/10.1186/s12875-018-0725-6
  32. Tuppal, C. P., Ninobla, M. M. G., Ruiz, M. G. D., Loresco, R. D., Tuppal, S. M. P., Panes, I. I., Oducado, R. M. F., Prudencio, D. A. M., Vega, P. D., Eribal, M. J. E., Real, D. V. P., & Roa, M. N. T. (2021). Knowledge, attitude, and practice toward COVID-19 among healthy population in the Philippines. Nurse Media Journal of Nursing, 11(1), 61-70. https://doi.org/10.14710/nmjn.v11i1.36067
  33. Wang, N., Wang, S., Qian, H.-Z., Ruan, Y., Amico, K. R., Vermund, S. H., Zheng, S. (2019). Negative associations between general self-efficacy and anxiety/depression among newly HIV-diagnosed men who have sex with men in Beijing, China. AIDS Care, 31(5), 629-635. https://doi.org/10.1080/09540121.2018.1549721
  34. Weng, L. C., Dai, Y. T., Wang, Y. W., Huang, H. L., & Chiang, Y. J. (2008). Effects of self‐efficacy, self‐care behaviours on depressive symptom of Taiwanese kidney transplant recipients. Journal of Clinical Nursing, 17(13), 1786-1794. https://doi.org/10.1111/j.1365-2702.2007.02035.x
  35. Wu, S.-F. V., Huang, Y.-C., Lee, M.-C., Wang, T.-J., Tung, H.-H., & Wu, M.-P. (2013). Self-efficacy, self-care behavior, anxiety, and depression in Taiwanese with type 2 diabetes: A cross-sectional survey. Nursing & Health Sciences, 15(2), 213-219. https://doi.org/10.1111/nhs.12022
  36. Wu, Z., & McGoogan, J. M. (2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. Jama, 323(13), 1239-1242. https://doi.org/10.1001/jama.2020.2648
  37. Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020). The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e923549-923541. https://doi.org/10.12659/MSM.923549
  38. Xue, A., Oros, V., La Marca-Ghaemmaghami, P., Scholkmann, F., Righini-Grunder, F., Natalucci, G., Restin, T. (2021). New parents experienced lower parenting self-efficacy during the COVID-19 pandemic lockdown. Children, 8(2),79. https://doi.org/10.3390/children8020079
  39. Yıldırım, M., & Güler, A. (2020). COVID-19 severity, self-efficacy, knowledge, preventive behaviors, and mental health in Turkey. Death Studies, 46(4), 1-8. https://doi.org/10.1080/07481187.2020.1793434
  40. Zhang, S. X., Wang, Y., Rauch, A., & Wei, F. (2020). Health, distress, and life satisfaction of people one-month into COVID-19 outbreak in China. Psychiatric Research, 288(1), 112958. https://doi.org/10.1016/j.psychres.2020.112958

Last update:

  1. Massachusetts General Hospital Comprehensive Clinical Psychiatry

    Stephanie Sogg, Sanjeev Sockalingam, Susan Himes, Susan J. Penava, Noreen A. Reilly-Harrington. 2025. doi: 10.1016/B978-0-443-11844-9.00072-2

  2. Correlating Demographics and Well-being among Rural College Students in the Philippines

    Resti Tito Villarino, Maureen Lorence Villarino, Maria Concepcion Temblor, Prosper Bernard, Michel Plaisent. Nurse Media Journal of Nursing, 13 (1), 2023. doi: 10.14710/nmjn.v13i1.49036

  3. Dissecting Supplement and Nutrients Intake of Adults with and without COVID-19 History through the Lens of Health Belief Model

    Trias Mahmudiono, Cindra Tri Yuniar, Risti Kurnia Dewi, Qonita Rachmah, Dominikus Raditya Atmaka, Eurika Zebadia, Nur Sahila, Mutiara Arsya Vidianinggar Wijanarko, Chika Dewi Haliman, Shirley Gee Hoon Tang. Nutrients, 14 (21), 2022. doi: 10.3390/nu14214450

  4. The effect of theory-based education on self-care among elderly in Ilam, Iran

    Sanam Amiri, Mohamad Sadegh AbedzadehZavareh, Mahmoud Tavousi, Reza Jorvand. Payesh (Health Monitor) Journal, 23 (4), 2024. doi: 10.61186/payesh.23.4.571

Last update: 2024-11-21 18:56:06

No citation recorded.