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Patient and Disease Characteristics Associated with Activation for Self-Management in Patients with Diabetes, Chronic Obstructive Pulmonary Disease, Chronic Heart Failure and Chronic Renal Disease: A Cross-Sectional Survey Study

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  • Irene Bos-Touwen
  • Marieke Schuurmans
  • Evelyn M Monninkhof
  • Yvonne Korpershoek
  • Lotte Spruit-Bentvelzen
  • Inge Ertugrul-van der Graaf
  • Niek de Wit
  • Jaap Trappenburg

Abstract

A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater part of the factors that contribute to the complex nature of patient activation for self-management.

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  • Irene Bos-Touwen & Marieke Schuurmans & Evelyn M Monninkhof & Yvonne Korpershoek & Lotte Spruit-Bentvelzen & Inge Ertugrul-van der Graaf & Niek de Wit & Jaap Trappenburg, 2015. "Patient and Disease Characteristics Associated with Activation for Self-Management in Patients with Diabetes, Chronic Obstructive Pulmonary Disease, Chronic Heart Failure and Chronic Renal Disease: A ," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-15, May.
    • Handle: RePEc:plo:pone00:0126400
    DOI: 10.1371/journal.pone.0126400
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    References listed on IDEAS

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    1. Colin D Mathers & Dejan Loncar, 2006. "Projections of Global Mortality and Burden of Disease from 2002 to 2030," PLOS Medicine, Public Library of Science, vol. 3(11), pages 1-20, November.
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    1. Ann‐Britt Zakrisson & Mats Arne & Karin Lisspers & Lena Lundh & Hanna Sandelowsky & Björn Ställberg & Eva Thors Adolfsson & Kersti Theander, 2020. "Improved quality of care by using the PRISMS form to support self‐management in patients with COPD: A Randomised Controlled Trial," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(13-14), pages 2410-2419, July.
    2. Bischof, Anja, 2023. "The power of knowledge: A survey on COPD patients' health literacy in Switzerland," Working Paper Series in Health Economics, Management and Policy 2023-04, University of St.Gallen, School of Medicine, Chair of Health Economics, Policy and Management.
    3. Cynthia F. Corbett & Kenn B. Daratha & Sterling McPherson & Crystal L. Smith & Michael S. Wiser & Brenda K. Vogrig & Sean M. Murphy & Roy Cantu & Dennis G. Dyck, 2021. "Patient Activation, Depressive Symptoms, and Self-Rated Health: Care Management Intervention Effects among High-Need, Medically Complex Adults," IJERPH, MDPI, vol. 18(11), pages 1-14, May.
    4. Uday Narayan Yadav & Jane Lloyd & Hassan Hosseinzadeh & Kedar Prasad Baral & Narendra Bhatta & Mark Fort Harris, 2020. "Levels and determinants of health literacy and patient activation among multi-morbid COPD people in rural Nepal: Findings from a cross-sectional study," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-16, May.
    5. Tomoko Kamei & Yuko Yamamoto & Takuya Kanamori & Yuki Nakayama & Sarah E. Porter, 2018. "Detection of early‐stage changes in people with chronic diseases: A telehome monitoring‐based telenursing feasibility study," Nursing & Health Sciences, John Wiley & Sons, vol. 20(3), pages 313-322, September.
    6. Dorota Włodarczyk & Joanna Chylińska, 2022. "Profiles of Health-Related Patient Activation and Their Determinants: The Results of a Cluster Analysis of Older Adults—Conclusions for Patient Counselling," IJERPH, MDPI, vol. 19(4), pages 1-12, February.

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