{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:49Z","timestamp":1787027809466,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Health beliefs, disease acceptance, and self-efficacy significantly influence patients\u2019 behavior. This study examined factors associated with self-efficacy and illness acceptance in patients with heart failure (HF). The study, conducted from June 2022 to June 2024, included 231 patients aged \u2265 65 years hospitalized for HF. Self-efficacy and illness acceptance were assessed using the Generalized Self-Efficacy Scale (GSES) and Acceptance of Illness Scale (AIS). The median age of participants was 80 years (72\u201386); a total of 63.6% were women. The AIS score median was 25, indicating moderate disease acceptance, while the GSES score median was 30, reflecting relatively high self-efficacy. Lower GSES scores were associated with a history of cancer (p = 0.002) and geriatric depression (p = 0.000). Poor illness acceptance was linked to prior myocardial infarction (p = 0.020), atrial fibrillation (p = 0.008), stroke (p = 0.040), depression (p = 0.000), and frailty (p = 0.000). Frailty (OR 0.81) and cancer history (OR 3.08) independently predicted self-efficacy, while lower illness acceptance was linked to older age (OR 0.95), stressful events (OR 0.53), stroke (OR 0.26), and improved by physical activity (OR 1.22). Our results indicated that older HF patients exhibit high self-efficacy but moderate illness acceptance. Self-efficacy is influenced by frailty and cancer history, while illness acceptance by age, stress, stroke, and physical activity.<\/jats:p>","DOI":"10.3390\/bs15050679","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T09:58:27Z","timestamp":1747303107000},"page":"679","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Self-Efficacy and Acceptance of Illness Among Older Patients with Heart Failure"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1434-2138","authenticated-orcid":false,"given":"Urszula","family":"Religioni","sequence":"first","affiliation":[{"name":"School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Kupisz-Urba\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland"},{"name":"Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9843-8048","authenticated-orcid":false,"given":"Wiktoria","family":"Niegowska","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Drab","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Statistics with E-Learning Laboratory, Medical University of Lublin, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Czapski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Januszewska-Mukarker","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1015-9643","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Pinkas","sequence":"additional","affiliation":[{"name":"School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4844-7391","authenticated-orcid":false,"given":"Beata","family":"Gellert","sequence":"additional","affiliation":[{"name":"School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1847-512X","authenticated-orcid":false,"given":"Janusz","family":"Ostrowski","sequence":"additional","affiliation":[{"name":"School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr","family":"Jankowski","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 00-416 Warsaw, Poland"},{"name":"Department of Epidemiology and Health Promotion, School of Public Health, Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Association between self-efficacy and health behaviour in disease control: A systematic review","volume":"10","author":"Affendi","year":"2018","journal-title":"Global Journal of Health Science"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bonikowska, I., Szwamel, K., and Uchmanowicz, I. (2021). Analysis of the impact of disease acceptance, demographic, and clinical variables on adherence to treatment recommendations in elderly type 2 diabetes mellitus patients. International Journal of Environmental Research and Public Health, 18, (16).","DOI":"10.3390\/ijerph18168658"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1111\/nhs.12704","article-title":"Positive psychological constructs and health behavior adherence in heart failure: A qualitative research study","volume":"22","author":"Celano","year":"2020","journal-title":"Nursing & Health Sciences"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Cybulski, M., Cybulski, L., Krajewska-Kulak, E., and Cwalina, U. (2017a). Illness acceptance, pain perception, and expectations for physicians of the elderly in Poland. BMC Geriatrics, 17.","DOI":"10.1186\/s12877-017-0441-4"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"305","DOI":"10.2147\/CIA.S128717","article-title":"The level of emotion control, anxiety, and self-efficacy in the elderly in Bia\u0142ystok, Poland","volume":"12","author":"Cybulski","year":"2017b","journal-title":"Clinical Interventions in Aging"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"269","DOI":"10.26444\/aaem\/144197","article-title":"Normalization of the AIS (Acceptance of Illness Scale) questionnaire and its use among cancer patients","volume":"29","author":"Czerw","year":"2022","journal-title":"Annals of Agricultural and Environmental Medicine"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.amjmed.2022.10.019","article-title":"Understanding health attitudes and behavior","volume":"136","author":"Fava","year":"2023","journal-title":"The American Journal of Medicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1002\/ejhf.1858","article-title":"Epidemiology of heart failure","volume":"22","author":"Groenewegen","year":"2020","journal-title":"European Journal of Heart Failure"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12955-016-0413-y","article-title":"Association between general self-efficacy, social support, cancer-related stress, and physical health-related quality of life: A path model study in patients with neuroendocrine tumors","volume":"14","author":"Haugland","year":"2016","journal-title":"Health and Quality of Life Outcomes"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s11897-017-0324-1","article-title":"Factors related to self-care in heart failure patients according to the middle-range theory of self-care of chronic illness: A literature update","volume":"14","author":"Jaarsma","year":"2017","journal-title":"Current Heart Failure Reports"},{"key":"ref_11","unstructured":"Juczy\u0144ski, Z. (2001). Measurement tools in health promotion and psychology, Laboratory of Psychological Tests."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"K\u00e4rner K\u00f6hler, A., Tingstr\u00f6m, P., Jaarsma, T., and Nilsson, S. (2018). Patient empowerment and general self-efficacy in patients with coronary heart disease: A cross-sectional study. BMC Family Practice, 19.","DOI":"10.1186\/s12875-018-0749-y"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3200\/JRLP.139.5.439-457","article-title":"The general self-efficacy scale: Multicultural validation studies","volume":"139","author":"Luszczynska","year":"2005","journal-title":"Journal of Psychology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.2147\/CIA.S178393","article-title":"Capability for self-care of patients with heart failure","volume":"13","author":"Mlynarska","year":"2018","journal-title":"Clinical Interventions in Aging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/JCN.0000000000000365","article-title":"Direction of the relationship between acceptance of illness and health-related quality of life in chronic heart failure patients","volume":"32","author":"Siennicka","year":"2017","journal-title":"Journal of Cardiovascular Nursing"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1111\/jocn.16104","article-title":"Understanding relationships between general self-efficacy and the healthy ageing of older people: An integrative review","volume":"32","author":"Remm","year":"2023","journal-title":"Journal of Clinical Nursing"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"151583","DOI":"10.1016\/j.apnr.2022.151583","article-title":"Illness acceptance, medication adherence, and quality of life in patients with heart failure: A path analysis of a conceptual model","volume":"65","author":"Sadeghiazar","year":"2022","journal-title":"Applied Nursing Research"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.11124\/JBISRIR-2016-003244","article-title":"Risk factors for readmission to hospital in adult patients with heart failure and reduced ejection fraction: A systematic review protocol","volume":"15","author":"Larsen","year":"2017","journal-title":"JBI Database of Systematic Reviews and Implementation Reports"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"168","DOI":"10.5603\/KP.a2015.0137","article-title":"Perception of health control and self-efficacy in heart failure","volume":"74","author":"Siennicka","year":"2016","journal-title":"Kardiologia Polska"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5114\/reum\/168294","article-title":"Life satisfaction, generalized sense of self-efficacy and acceptance of illness in rheumatoid arthritis patients depending on age and severity of the disease","volume":"61","author":"Staszkiewicz","year":"2023","journal-title":"Reumatologia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1080\/13548506.2022.2125165","article-title":"The relationship between depression and subjective cognitive decline in older adults of China: The mediating role of general self-efficacy","volume":"28","author":"Su","year":"2023","journal-title":"Psychology, Health & Medicine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1080\/09602011.2017.1418392","article-title":"General self-efficacy as a driving factor of post-stroke depression: A longitudinal study","volume":"29","author":"Volz","year":"2019","journal-title":"Neuropsychological Rehabilitation"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.pec.2021.05.024","article-title":"Health beliefs associated with preventive behaviors against noncommunicable diseases","volume":"105","author":"Wang","year":"2022","journal-title":"Patient Education and Counseling"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Wang, Y., Xu, L., Qin, W., Zhang, J., Xia, Y., Jing, X., Lu, L., Jiao, A., and Li, Y. (2019). Gender difference in general self-efficacy among young-old elderly aged 60\u201374 in rural Shandong, China: A cross-sectional survey. International Journal of Environmental Research and Public Health, 16, (24).","DOI":"10.3390\/ijerph16245070"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e302","DOI":"10.1093\/geront\/gnaa036","article-title":"The general self-efficacy of older adults receiving care: A systematic review and meta-analysis","volume":"61","author":"Whitehall","year":"2021","journal-title":"Gerontologist"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/5\/679\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:33:25Z","timestamp":1760031205000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/5\/679"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,15]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["bs15050679"],"URL":"https:\/\/doi.org\/10.3390\/bs15050679","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,15]]}}}