{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:44:30Z","timestamp":1791945870265,"version":"4.3.4"},"reference-count":69,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T00:00:00Z","timestamp":1780185600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To examine the role of self\u2010efficacy in the relationship between medication adherence and self\u2010care behaviours in patients with Inflammatory Bowel Disease by describing their levels and exploring the interconnections among these variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Multicenter, cross\u2010sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 452 patients were recruited through consecutive non\u2010probabilistic sampling across nine Italian outpatient Inflammatory Bowel Disease Units. Data were collected using validated tools: the Morisky Medication Adherence Scale\u20108, the Self\u2010Care Self\u2010Efficacy Scale, and the Self\u2010Care of Chronic Illness Inventory. Descriptive statistics, Pearson correlations, and mediation analyses were performed to explore associations and the mediating role of self\u2010efficacy between medication adherence and self\u2010care behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants had a mean age of 43.49\u2009years; 50.9% were male, 49.2% had Crohn's disease, and 50.8% had ulcerative colitis. Only 10.2% reported high medication adherence, while most showed medium or low adherence. The mean self\u2010efficacy score was 74.82. Medication adherence was positively associated with self\u2010care maintenance, and self\u2010efficacy statistically accounted for part of this association. Lower levels were observed in self\u2010care monitoring and management behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Medication adherence was positively associated with self\u2010care maintenance, and self\u2010efficacy partially explained this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Clinical Practice<\/jats:title>\n                    <jats:p>Routine assessment of medication adherence and self\u2010efficacy may help identify patients at risk of poor self\u2010care. Interventions aimed at strengthening self\u2010efficacy, such as motivational interviewing, nurse\u2010led counselling, and digital monitoring tools, may improve adherence and self\u2010care maintenance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>The study addressed low medication adherence and suboptimal self\u2010care in patients with IBD. Findings support integrating self\u2010efficacy\u2010enhancing strategies into multidisciplinary care to improve adherence and self\u2010care behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Patients completed validated self\u2010report questionnaires; however, they were not involved in the study design, conduct, analysis, or manuscript preparation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70385","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T06:05:41Z","timestamp":1780293941000},"page":"4378-4388","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Self\u2010Efficacy as a Mediator Between Medication Adherence and Self\u2010Care in Inflammatory Bowel Disease: A Multicenter Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7279-7235","authenticated-orcid":false,"given":"Piergiorgio","family":"Martella","sequence":"first","affiliation":[{"name":"Neuroscience Department, Neurosurgery Care Management Gemelli IRCCS University Hospital Foundation  Rome Italy"},{"name":"Department of Biomedicine and Prevention Tor Vergata University  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2834-7594","authenticated-orcid":false,"given":"Manuele","family":"Cesare","sequence":"additional","affiliation":[{"name":"A. Gemelli IRCCS University Hospital Foundation  Rome Italy"},{"name":"Section of Hygiene, University Department of Life Sciences and Public Health Catholic University of the Sacred Heart  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2756-9929","authenticated-orcid":false,"given":"Silvia","family":"Cilluffo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences for Health University of Milan  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3232-9447","authenticated-orcid":false,"given":"Alessandro","family":"Monaci","sequence":"additional","affiliation":[{"name":"Nursing Direction Paideia International Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8713-2051","authenticated-orcid":false,"given":"Valentina","family":"Biagioli","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences (DIMEC) University of Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6494-1190","authenticated-orcid":false,"given":"Davide","family":"Bartoli","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Wellbeing, Health and Environmental Sustainability \u2013 BeSSA Department Sapienza University of Rome  Rieti Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2481-5354","authenticated-orcid":false,"given":"Daniele","family":"Napolitano","sequence":"additional","affiliation":[{"name":"SITRA and Scientific Direction  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7694-4986","authenticated-orcid":false,"given":"Antonello","family":"Cocchieri","sequence":"additional","affiliation":[{"name":"A. 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