Analysis of the core and bridge effects of interpersonal, relaxation and medication efficacy in self-management of rheumatoid arthritis patients

To explore the networked association among the dimensions of self-efficacy in patients with rheumatoid arthritis (RA) and to identify core efficacy and bridge efficacy, and provide a basis for formulating precise nursing intervention strategies.

A total of 652 RA patients admitted in our hospital from September 2024 to January 2025 were enrolled with convenience sampling. The general information questionnaire and Rheumatoid Arthritis Self-Efficacy Scale (RASE) were used for assessment. Exploratory factor analysis was used to extract efficacy symptom clusters. With aid of R project, network analysis was employed to construct an association network among efficacy dimensions to calculate centrality indicators (strength, closeness, betweenness) to identify core efficacy and bridge efficacy.

Exploratory factor analysis extracted 7 efficacy symptom clusters, with a cumulative variance contribution rate of 64. 539% (P<0.001). Network analysis showed that the network density was 0.143, suggesting that there were moderate correlations among the self-efficacy dimensions. “Relaxation efficacy 1 (r1)” and “pain efficacy 1 (a1)” had the strongest correlation (r=0.73). Interpersonal efficacy 2 (i2) had the highest intensity centrality (6.88), and relaxation efficacy 3 (r3) had the highest tightness (0.0125), and medication efficacy 1 (m1) had the highest mediation (116), which were the core efficacy and bridge efficacy in this network group.

There are complex network-like correlations among the various dimensions of self-efficacy in RA patients. Interpersonal efficacy is the core driving factor, while relaxation and medication efficacies play the bridging role, jointly influencing the overall level of patients’self-management ability.