The Predictive Influence of Self-Efficacy and Socioeconomic Factors on the Physical and Mental Health-Related Quality of Life of Adolescents and Young Adults with Sickle Cell Disease

Sickle cell disease (SCD), an inherited disorder of haemoglobin, is associated with severe physical and psychological burdens, both of which are influenced by a wide range of cognitive and socio-environmental factors. The current study aimed to establish the predictive influence of self-efficacy and family socioeconomic factors on the physical and mental health-related quality of life (HRQoL) of adolescents and young adults (AYA) with SCD. A cross-sectional study design was adopted, involving a sample of 116 AYAs with SCD, aged 16 to 24, recruited from two health facilities in South-West Nigeria. Participants completed assessments of SCD self-efficacy using the Sickle Cell Self-Efficacy Scale (SCSES) and HRQoL using the physical and mental component summary measures of the Short-Form 36 (SF-36). Family socioeconomic factors and socioeconomic status were evaluated using a Family Socioeconomic Status Scale adopted for the study. Multiple regression analysis indicated a significant joint influence of self-efficacy and socioeconomic factors on both physical and mental HRQoL, accounting for 64% variance in physical HRQoL and 66% variance in mental HRQoL. All evaluated variables, except home sanitation, independently predicted physical HRQoL, while all variables, except education and occupation, independently predicted mental HRQoL. Family possession, family-specific factors, and home sanitation were the most significant socioeconomic predictors of both physical and mental HRQoL. Moderation analysis indicated that socioeconomic status significantly moderated the influence of self-efficacy on mental HRQoL but not on physical HRQoL. The study highlights the need for exploring comprehensive and multi-faceted approaches in the management of SCD that go beyond medical treatment to address the broader social and psychological factors that influence physical and mental HRQoL.