Unraveling the Link between Self-efficacy and self-management in Breast Cancer Patients during the COVID-19 Pandemic: A Cross-sectional Study

Background: The COVID-19 pandemic necessitates that cancer patients take on a more active role in self-managing their illness and adjusting to the altered healthcare resources. To perform self-management behaviors, patients may need an adequate level of self-efficacy. However, little is known about breast cancer patients’ self-efficacy and self-management in pandemic times. Aim: This study aimed to assess the self-efficacy and self-management of breast cancer patients undergoing therapy during the COVID-19 pandemic and identify their associations. Methods: A descriptive-analytical, cross-sectional design was used. One hundred and eight breast cancer patients undergoing treatment were recruited from the National Cancer Center in Indonesia. Participants completed questionnaires that consisted of the Cancer Behavior Inventory, the Depression Anxiety Stress Scale, the Enrichd Social Support Instrument, and the Self-Management Assessment Scale. Data were analyzed using multiple regression. Results: The study found that 45.4% and 42.6% of breast cancer patients under treatment had a low level of self-efficacy and self-management, respectively. Self-efficacy is positively associated with self-management in breast cancer patients (p=0.001) after controlling for various factors, including cancer stage, psychological factors, and social support. The factor most related to self-management is self-efficacy, as measured by the odds ratio (OR), which was 16.713 (95% CI: 4.424-63.137), while the ORs of social support and stage were 4.968 (95% CI: 1.785-13.831) and 0.190 (95% CI: 0.044-0.820), respectively. Conclusion: It can be concluded that self-efficacy is strongly and positively associated with self-management in breast cancer patients undergoing treatment. Therefore, nursing interventions focusing on enhancing patients’ self-efficacy are needed.