Incorporating Self-Efficacy Theory to Awake Prone Positioning in COVID-19 Patients: A Single-Center Perspective Study

Abstract

Objective: This study sought to examine whether the inclusion of self-efficacy theory could increase the effectiveness of awake prone positioning in COVID-19 patients. Method: A total of 80 COVID-19 patients admitted to the respiratory department of our hospital between December 2022 and February 2023 were randomly allocated into either the intervention group (n=40) or the control group (n=40). The control group received routine respiratory medicine treatment and underwent awake prone positioning, whereas the intervention group received additional self-efficacy theory intervention alongside awake prone positioning. The patients’ oxygen saturation level (SpO2) and respiratory rate (RR) were closely monitored at three different time points: before awake prone positioning, 30 minutes and 1 hour after awake prone positioning. Furthermore, the patients’ Modified Medical Research Council (mMRC) dyspnea scale and self-efficacy scores were evaluated on the first, second, and third days of awake prone positioning. The cumulative duration of awake prone positioning and patient satisfaction were recorded on the third day of the intervention. Results: The data indicate that the intervention group demonstrated significant improvements in both SpO2 and RR compared to the control group, both at 1 hour and at the end of awake prone positioning (P＜0.05). Moreover, the intervention group experienced a substantial reduction in the dyspnea index compared to the control group on the second and third day (P＜0.05). The intervention group also reported higher self-efficacy scores, cumulative duration of awake prone positioning ventilation on the third day, and satisfaction levels compared to the control group on the first, second, and third day (P<0.05). Conclusions: The incorporation of self-efficacy theory to awake prone positioning improves the short-term outcomes of COVID-19 patients. This patient-centered approach has the potential to increase patients’ self-efficacy and satisfaction levels, emphasizing the importance of incorporating patient-centered care in healthcare practices.