Autoeficácia de pessoas com doença celíaca no cumprimento da dieta isenta de glúten: avaliação por meio de escalas

Abstract

Introduction: Adherence to a gluten-free diet (GFD) is challenging for individuals with celiac disease (CD), and self-efficacy plays a central role. Objective: To analyze the self-efficacy of individuals with CD in adhering to a GFD using the Celiac Self-Efficacy Scale (Celiac-SE) and the General Self-Efficacy Scale-12 (GSE-12). Method: This was a cross-sectional study conducted with 266 individuals diagnosed with CD, recruited through social media. Participants completed electronic questionnaires including sociodemographic and clinical data, as well as two self-efficacy scales: the Celiac-SE, specific for measuring self-efficacy in maintaining a GFD in CD, and the GSE-12, a general scale focused on perceived self-efficacy in everyday situations. The Celiac-SE consists of 25 items rated on a Likert scale from 0 (not at all capable) to 10 (completely capable), with higher scores indicating greater self-efficacy. Cutoff points were defined as 0–3.9 (low), 4–6.9 (moderate), and 7–10 (high self-efficacy). The GSE-12 comprises 12 items with a 5-point scale, with the following cutoffs: 1.0–2.4 (high), 2.5–3.9 (moderate), and 4.0–5.0 (low self-efficacy). Analyses included descriptive statistics, mean comparison tests (Mann-Whitney), and Spearman correlation, with a 5% significance level. All ethical standards for research involving human subjects were respected (approval number 6.443.306). Results: Regarding specific self-efficacy (Celiac-SE), the mean global score was 5.0, indicating a moderate level of confidence in GFD adherence, with the highest scores in items related to resisting food temptations at home and during travel. The lowest scores were observed in shopping situations and under social pressure. For six items of the GSE-12, results indicated low self-efficacy, suggesting strong agreement with statements related to giving up, avoidance, or insecurity in the face of challenges. In the remaining six items, participants demonstrated confidence in facing everyday challenges and persistence in decision-making. Statistically significant differences were found in specific scale items when compared by sex, association membership, private health insurance coverage, and use of the public health system, particularly in travel, workplace, or dietary decision scenarios. Conclusion: The findings suggest that self-efficacy perception is influenced by contextual, interpersonal, and structural factors such as access to healthcare and institutional affiliation. The Celiac-SE yielded higher scores, especially in situations under the individual’s control, while the GSE-12 revealed lower levels of general self-efficacy in half of the items, with greater agreement with statements reflecting insecurity and withdrawal.