Enabling or cultivating? The interplay of support and self-efficacy in the context of pelvic-floor exercise

Abstract

Background: To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic-floor exercise (PFE). Patients’ self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling hypothesis), self-efficacy may cultivate support (cultivation hypothesis). Thus, in this longitudinal study cross-lagged inter-relationships among self-efficacy, support, and PFE are investigated. Methods: Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at 4 times. Autoregressive models tested interrelations among variables, either using patients’ or partners’ reports of support. Findings: Models using patients’ data revealed positive associations between self-efficacy and changes in received support, which predicted increases in PFE. Using partners’ accounts of support provided, these associations were replicated. Furthermore, partner-provided support was related with increases in patients’ self-efficacy. Discussion: Patients’ self-efficacy may cultivate partners’ support provision for patients’ PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.