Predictors of Self-Care Self-Efficacy in Adults Familiar with Palliative Care: The Role of Patient-Centered Communication, Health, and Well-Being.

Background: Understanding the determinants of self-care self-efficacy (SS) is essential to improving health outcomes in patients facing advanced disease. This study contributes to the field by examining the direct and indirect effects of quality of care (QC), patient-centered communication (PCC), perceived health (PH), and emotional well-being (EW) on SS in American adults with knowledge of palliative care. Methods: A predictive-crossover design study was conducted. Data from N = 1154 adult respondents to the 2018 Health Information National Trends Survey (HINTS) 5, cycle 2 were used. Structural Equation Modeling (SEM) was used to report the direct and indirect effects for the proposed mediation model. Results: QC had a strong, significant association with PCC (β =0.930, p <0.001). PCC was significantly associated with PH (β =0.104, p <0.01) and EW (β =0.098, p <0.01), but not directly with SS (β =0.030, p >0.05). SS was significantly predicted by PH (β =0.659, p <0.001) and EW (β =0.178, p <0.001). Indirect effects of PCC on SS via PH and EW were confirmed. Conclusion: These findings highlight the importance of promoting perceived health and emotional well-being as key mechanisms by which care quality and communication impact self-efficacy. This study underscores the need to prioritize patient perceptions in palliative care interventions aimed at enhancing self-care capacity.