Self-Efficacy and Its Associations with Sweat Pro-Inflammatory Cytokine Interleukin-6 and Pre-Frailty/Frailty among Older Adults with Chronic Disease

older adults;cytokine;sweat patch;frailty;Nursing

Hladek, Melissa deCardiBandeen-Roche, Karen ;

Johns Hopkins University

关键词: older adults;    cytokine;    sweat patch;    frailty;    Nursing;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/60044/HLADEK-DISSERTATION-2018.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Problem StatementChronic disease affects over 117 million US adults1 and is more prevalent in older adults2. Likewise, 15% of community dwelling older adults are frail, which is a state of decreased physiologic reserve associated with many negative health outcomes.Self-management programs to aid in chronic disease and frailty management are commonly based on the concept of self-efficacy, which is the confidence to be successful at specific tasks or life domains. In the context of health and illness, higher self-efficacy is associated with healthier behaviors and positive health outcomes. Although inflammation is common in older adults with chronic diseases, not all have the same amount or degree of poor health outcomes from the inflammation or chronic diseases. Self-efficacy is integral to successful disease management but it is unclear if and how this relates to inflammation.The purpose of this study was to evaluate associations between self-efficacy and frailty as well as self-efficacy and Interleukin-6 (IL-6), which is an inflammatory cytokine highly associated with all-cause morbidity and mortality. MethodsWe conducted a two-visit cross-sectional study with 159 community dwelling adults ages 65 and older in Maryland.All participants had at least one chronic condition (e.g. hypertension, diabetes, arthritis, etc.) Those with a terminal illness diagnosis, active cancer treatment, cognitive impairment or progressive neurological conditions were excluded. Sweat IL-6, frailty status, self-efficacy, number of chronic diseases, social support and other socio-demographic data were collected.Sweat was collected using a non-invasive sweat patch worn for 72 hours by each participant. We used multiple linear regression and logistic regression to examine whether self-efficacy was associated with sweat IL-6 and frailty after controlling for co-variates.ResultsThere was a significant relationship between social coping self-efficacy and IL-6 (β= -0.544, p=0.006) that remained significant after adjustment for age, sex, race, body mass index, number of chronic conditions and social support (β= -0.534, p=0.010).High self-efficacy was significantly related to lower IL-6.High self-efficacy was associated with an 91% reduction in the odds of pre-frailty/frailty after adjustment for age, race, co-morbidities, cardiovascular disease, heart rate, a life events count, illness intrusiveness, depressive symptoms and financial strain.High self-efficacy was associated with a more robust state.ConclusionsAlthough preliminary, this could shed light on the mechanistic connection between psychological and physical states.Enhancing self-efficacy might also be a viable non-pharmacological treatment to lower or slow inflammatory burden or frailty status in older adults.