# Psychological determinants of self-management in migrants with chronic non-communicable diseases: self-efficacy and self-esteem

## TL;DR

This study explores how self-efficacy and self-esteem influence the self-management of chronic diseases among South American migrants in Chile.

## Contribution

The study identifies self-efficacy as a stronger mediator than self-esteem in self-management of CNCDs among South-South migrants.

## Key findings

- Self-efficacy has a positive and direct relationship with self-management of CNCDs.
- Self-esteem also has a positive and direct relationship with self-management of CNCDs.
- Self-efficacy is a more robust mediator than self-esteem in linking to self-management of CNCDs.

## Abstract

Within the framework of migration as a social determinant of health, it is important to study the psychological factors associated with self-management of chronic non-communicable diseases (CNCDs), a topic that has been little studied in south-south migrant populations. The present study aimed to analyze two mediation models. The first describes the effect of individual self-esteem as a mediator of the relationship between self-efficacy and self-management of CNCDs. The second model describes the effect of self-efficacy as a mediator in the relationship between self-esteem and self-management of CNCDs in South American migrants residing in Chile. A survey was conducted among 241 South-South migrants diagnosed with CNCDs and residing in five cities in Chile. Four ad hoc scales were applied to assess the study variables, analyzing the measurement models for each of them using the confirmatory factor analysis method. Subsequently, the hypothetical mediation model was evaluated using Structural Equation Modeling (SEM). The results show that self-efficacy has a positive and direct relationship with self-management of CNCDs, and self-esteem has a positive and direct relationship with self-management of CNCDs. Furthermore, both self-esteem and self-efficacy showed significant mediating effects in the association with self-management of CNCDs. While self-esteem acted as a relevant personal resource associated with self-efficacy, self-efficacy emerged as the more proximal and robust mediating mechanism linking self-esteem to self-management of CNCDs.