Self-Efficacy Mediates the Dyadic Relationship Between Psychological Distress and Self-Care in Individuals With Inflammatory Bowel Disease and Their Caregivers

Key Takeaways for GI Nurses

• Self-efficacy serves as a critical bridge between psychological distress and self-care behaviors in IBD patients and their caregivers, suggesting that interventions targeting confidence in disease management may be more effective than addressing distress alone
• The dyadic relationship between patients and caregivers creates interconnected psychological and self-care patterns, requiring nursing assessments and interventions that consider both parties rather than focusing solely on the patient
• Psychological distress in IBD management appears to impact self-care indirectly through its effect on self-efficacy, indicating that building patient and caregiver confidence may be key to improving adherence to treatment regimens
• Understanding this mediation pathway provides GI nurses with a framework for developing targeted educational and support interventions that strengthen both patient and caregiver capacity for disease management

Clinical Relevance

This research has significant implications for how GI and endoscopy nurses approach patient education and support interventions. Rather than addressing psychological distress and self-care as separate issues, nurses can focus on building self-efficacy as a strategic intervention point that influences both outcomes. In practical terms, this means developing educational programs that not only provide information about IBD management but also actively build confidence through skill demonstration, goal setting, and positive reinforcement strategies. When preparing patients for endoscopic procedures or discussing medication adherence, nurses should assess and address both the patient's and caregiver's confidence levels in managing various aspects of the disease.

The dyadic focus of this research emphasizes the importance of including caregivers in nursing assessments and interventions. Many GI units already recognize the value of caregiver involvement, but this study suggests that the psychological well-being and self-efficacy of caregivers directly impacts patient outcomes. This creates opportunities for nurses to expand their scope of care to include caregiver education sessions, support groups, and assessment tools that evaluate the caregiver's comfort level with various aspects of IBD management. From an operational standpoint, units may need to consider how to systematically include caregivers in care planning and education processes.

For professional development, this research supports the growing emphasis on holistic, family-centered care models in gastroenterology nursing. It provides evidence-based rationale for nurses to develop competencies in psychological assessment, motivational interviewing techniques, and dyadic counseling approaches. These skills complement traditional clinical competencies and may improve patient satisfaction scores, medication adherence rates, and overall quality of life outcomes for IBD patients and their families.

Bottom Line

GI nurses should prioritize building self-efficacy in both IBD patients and their caregivers as a strategic approach to improving self-care behaviors, recognizing that psychological distress impacts self-care primarily through its effect on confidence levels rather than directly. This means shifting from simply providing disease information to actively coaching patients and caregivers to feel confident and capable in managing IBD-related challenges, ultimately leading to better clinical outcomes and quality of life for the entire care dyad.