Self-Efficacy Mediates the Associations of Social Support and Depression with Treatment Adherence in Heart Failure Patients

  • Uta Maeda
  • Biing-Jiun Shen
  • Ernst R. Schwarz
  • Kristen A. Farrell
  • Stephen Mallon



Nonadherence to treatment recommendations is a leading preventable cause of rehospitalization and premature mortality in chronic heart failure (HF) patients.


This study examined whether self-efficacy mediates the contributions of social support and depression to treatment adherence.


A sample of 252 HF outpatients with a mean age of 54 years completed self-report questionnaires assessing depression, perceived social support, self-efficacy, and treatment adherence.


Self-efficacy mediated the associations of social support and depression with treatment adherence after adjusting for demographic (age, gender, marital status, education, and ethnicity) and medical (New York Heart Association Classification and comorbidity) covariates.


Self-efficacy explains the influence of social support and depression on treatment adherence and may be a key target for interventions to improve disease management and self-care behaviors in HF patients.


Heart failure Social support Depression Self-efficacy Adherence 



This research was supported by a grant from the American Heart Association.


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Copyright information

© International Society of Behavioral Medicine 2011

Authors and Affiliations

  • Uta Maeda
    • 1
  • Biing-Jiun Shen
    • 2
  • Ernst R. Schwarz
    • 3
  • Kristen A. Farrell
    • 4
  • Stephen Mallon
    • 5
  1. 1.Department of PsychologyUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Department of PsychologyOhio UniversityAthensUSA
  3. 3.Cedars-Sinai Medical CenterCedars-Sinai Heart InstituteLos AngelesUSA
  4. 4.Department of PsychologyUniversity of MiamiCoral GablesUSA
  5. 5.School of MedicineUniversity of MiamiMiamiUSA

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