advanced disease, nursing, patient-centered health care, questionnaire study, self-management



  1. Arslan, Muzeyyen MSc, PhD
  2. van Dongen, Sophie I. MSc
  3. Witkamp, Erica RN, MSc, PhD
  4. van Hooft, Susanne M. RN, MSc, PhD
  5. Billekens, Pascalle RN, MSc
  6. Kranenburg, Leonieke W. MSc, PhD
  7. Stoevelaar, Rik MSc, PhD
  8. van der Rijt, Carin C.D. MD, PhD
  9. van Dijk, Monique RN, PhD
  10. van der Heide, Agnes MD, PhD
  11. Rietjens, Judith A.C. Msc, PhD


This study aimed at investigating nurse practitioners' self-efficacy and behavior in supporting self-management of patients with a progressive, life-threatening illness and their relatives. We adapted an existing validated instrument for this purpose, amongst other things by adding a seventh subscale "attention for relatives," and administered it in a nationwide, cross-sectional online survey among Dutch nurse practitioners. We analyzed associations between self-reported self-efficacy and behavior using Pearson correlations and paired sample t tests. Associations between self-efficacy and behavior with nurse practitioners' characteristics were examined using linear regression models. Most nurse practitioners (n = 327; 26% complete responses) were women (93%). Subscale and total scores for nurse practitioners' self-efficacy were moderately positively correlated with those for their behavior in self-management support. Subscale and total scores were statistically significantly higher for their self-efficacy than for their behavior. Increased work experience with patients with a progressive, life-threatening illness was associated with higher scores on self-efficacy and behavior in self-management support. We conclude that nurse practitioners are confident in their ability to support self-management; yet, they do not always use these competencies in practice.