Role of “Self-Efficacy” in the Process of Long-Term Care in Kidney Transplant Recipients C. De Pasquale a,b, *, M.L. Pistorio a,b , D. Corona b , N. Sinagra b , A. Giaquinta b , D. Zerbo b , P. Veroux b , and M. Veroux b a Department of Formative Science, University of Catania, Catania, Italy; and b Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation and Advanced Technologies, University Hospital of Catania, Catania, Italy ABSTRACT Objective. This study investigated the relationship between self-efficacy, quality of life, and psychic dimensions of patients with kidney transplants. Given the considerable emotional implications and the risk of psychopathology after transplantation, a protective role is assumed of the sense of self-efficacy, both from any psychopathologic disorders and from a precarious quality of life. Methods. One hundred twenty recipients of kidney transplants from deceased donors were included in the study. The self-efficacy study was performed with the use of the General Self-Efficacy Scale. The quality of life of the subjects was studied with the use of the Short-Form Health Survey; The psychic symptoms of patients were performed using the Revised Symptom Checklist 90 (SCL-90R). Results. Self-efficacy is positively correlated with both physical role limitations and mental health. With increasing self-efficacy there was a decrease of psychic symptoms as investigated with the use of the SCL-90R test. Conclusions. This study demonstrated the “protective” function of the sense of self- efficacy in the psychic sphere and its positive effect on quality of life, in the sense that an appropriate problem-solving strategy helps the transplant patient to maintain good mental and physical health. H UMAN abilities to act on the events of life are numerous and heterogeneous, and everyone elabo- rates a personal perception of them, more or less corre- sponding to their own resources. Albert Bandura, one of the founders of cognitive psychology, who first conceptualized the psychologic dimension of “self-efficacy,” described it as “the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situa- tions” [1,2]. Self-efficacy, understood as the expectation and convic- tion to successfully deal with certain activities and situations according to one’s own skills, acts on the cognitive, affective, and motivational dimensions and plays a significant role in the management of acute or chronic stressful events [3e6]. Extended exposure to stress factors and any signs of lack of control lead to an activation of the neuroendocrinal, catecholaminergic, and endogenous opioid systems, with the presence of anxiety, depression, somatization, increased susceptibility to infections, and/or the development of other disorders [7]. Kidney transplantation, which represents a sudden change of the physical state of the subject, with the conse- quent abandonment of the sick role and retrieval of their autonomy, can cause stress and psychologic problems and then difficulties for the subject to follow a rigorous thera- peutic and rehabilitative post-transplantation program [8e12]. Any resistance to the program, hostility toward the medical staff, and poor compliance are the expression of “unconscious sabotage” by the subject, an unconscious *Address correspondence to Concetta de Pasquale, Vascular Surgery and Organ Transplant Unit, Department of Surgery, Transplantation, and Advanced Technologies, University Hospi- tal of Catania, Via Santa Sofia, 84, 95123 Catania, Italy. E-mail: depasqua@unict.it ª 2014 by Elsevier Inc. All rights reserved. 360 Park Avenue South, New York, NY 10010-1710 0041-1345/14 http://dx.doi.org/10.1016/j.transproceed.2014.07.035 Transplantation Proceedings, 46, 2235e2237 (2014) 2235