Determinants of activation for self-management in patients with COPD
COPD self-management is a complex behavior influenced by many factors. Despite scientific evidence that better disease outcomes can be achieved by enhancing self-management, many COPD patients do not respond to self-management interventions. To move toward more effective self-management intervention...
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| Veröffentlicht in: | International journal of chronic obstructive pulmonary disease 2016-01, Vol.11 (1), p.1757-1766 |
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| creator | Korpershoek, Yjg Bos-Touwen, I D de Man-van Ginkel, J M Lammers, J-Wj Schuurmans, M J Trappenburg, Jca |
| description | COPD self-management is a complex behavior influenced by many factors. Despite scientific evidence that better disease outcomes can be achieved by enhancing self-management, many COPD patients do not respond to self-management interventions. To move toward more effective self-management interventions, knowledge of characteristics associated with activation for self-management is needed. The purpose of this study was to identify key patient and disease characteristics of activation for self-management.
An explorative cross-sectional study was conducted in primary and secondary care in patients with COPD. Data were collected through questionnaires and chart reviews. The main outcome was activation for self-management, measured with the 13-item Patient Activation Measure (PAM). Independent variables were sociodemographic variables, self-reported health status, depression, anxiety, illness perception, social support, disease severity, and comorbidities.
A total of 290 participants (age: 67.2±10.3; forced expiratory volume in 1 second predicted: 63.6±19.2) were eligible for analysis. While poor activation for self-management (PAM-1) was observed in 23% of the participants, only 15% was activated for self-management (PAM-4). Multiple linear regression analysis revealed six explanatory determinants of activation for self-management (P |
| doi_str_mv | 10.2147/COPD.S109016 |
| format | Article |
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An explorative cross-sectional study was conducted in primary and secondary care in patients with COPD. Data were collected through questionnaires and chart reviews. The main outcome was activation for self-management, measured with the 13-item Patient Activation Measure (PAM). Independent variables were sociodemographic variables, self-reported health status, depression, anxiety, illness perception, social support, disease severity, and comorbidities.
A total of 290 participants (age: 67.2±10.3; forced expiratory volume in 1 second predicted: 63.6±19.2) were eligible for analysis. While poor activation for self-management (PAM-1) was observed in 23% of the participants, only 15% was activated for self-management (PAM-4). Multiple linear regression analysis revealed six explanatory determinants of activation for self-management (P<0.2): anxiety (β: -0.35; -0.6 to -0.1), illness perception (β: -0.2; -0.3 to -0.1), body mass index (BMI) (β: -0.4; -0.7 to -0.2), age (β: -0.1; -0.3 to -0.01), Global Initiative for Chronic Obstructive Lung Disease stage (2 vs 1 β: -3.2; -5.8 to -0.5; 3 vs 1 β: -3.4; -7.1 to 0.3), and comorbidities (β: 0.8; -0.2 to 1.8), explaining 17% of the variance.
This study showed that only a minority of COPD patients is activated for self-management. Although only a limited part of the variance could be explained, anxiety, illness perception, BMI, age, disease severity, and comorbidities were identified as key determinants of activation for self-management. This knowledge enables health care professionals to identify patients at risk of inadequate self-management, which is essential to move toward targeting and tailoring of self-management interventions. Future studies are needed to understand the complex causal mechanisms toward change in self-management.</description><identifier>ISSN: 1178-2005</identifier><identifier>ISSN: 1176-9106</identifier><identifier>EISSN: 1178-2005</identifier><identifier>DOI: 10.2147/COPD.S109016</identifier><identifier>PMID: 27536087</identifier><language>eng</language><publisher>New Zealand: Dove Medical Press Limited</publisher><subject>Aged ; Anxiety ; Anxiety - diagnosis ; Anxiety - psychology ; Body mass index ; Chronic illnesses ; Comorbidity ; Cross-Sectional Studies ; Depression - diagnosis ; Depression - psychology ; Female ; Forced Expiratory Volume ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Health Status ; Humans ; Linear Models ; Lung - physiopathology ; Male ; Medical research ; Middle Aged ; Original Research ; Patient Participation ; Perception ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Pulmonary Disease, Chronic Obstructive - psychology ; Pulmonary Disease, Chronic Obstructive - therapy ; Risk Factors ; Secondary Care ; Self Care ; Self Report ; Severity of Illness Index ; Social Support ; Socioeconomic factors ; Surveys</subject><ispartof>International journal of chronic obstructive pulmonary disease, 2016-01, Vol.11 (1), p.1757-1766</ispartof><rights>COPYRIGHT 2016 Dove Medical Press Limited</rights><rights>2016. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Korpershoek et al. This work is published and licensed by Dove Medical Press Limited 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c553t-68a1e168e6edd8b639629ca5e796fa496a4c440b417db5536c363f19d8da891a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976914/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976914/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,3849,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27536087$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Korpershoek, Yjg</creatorcontrib><creatorcontrib>Bos-Touwen, I D</creatorcontrib><creatorcontrib>de Man-van Ginkel, J M</creatorcontrib><creatorcontrib>Lammers, J-Wj</creatorcontrib><creatorcontrib>Schuurmans, M J</creatorcontrib><creatorcontrib>Trappenburg, Jca</creatorcontrib><title>Determinants of activation for self-management in patients with COPD</title><title>International journal of chronic obstructive pulmonary disease</title><addtitle>Int J Chron Obstruct Pulmon Dis</addtitle><description>COPD self-management is a complex behavior influenced by many factors. Despite scientific evidence that better disease outcomes can be achieved by enhancing self-management, many COPD patients do not respond to self-management interventions. To move toward more effective self-management interventions, knowledge of characteristics associated with activation for self-management is needed. The purpose of this study was to identify key patient and disease characteristics of activation for self-management.
An explorative cross-sectional study was conducted in primary and secondary care in patients with COPD. Data were collected through questionnaires and chart reviews. The main outcome was activation for self-management, measured with the 13-item Patient Activation Measure (PAM). Independent variables were sociodemographic variables, self-reported health status, depression, anxiety, illness perception, social support, disease severity, and comorbidities.
A total of 290 participants (age: 67.2±10.3; forced expiratory volume in 1 second predicted: 63.6±19.2) were eligible for analysis. While poor activation for self-management (PAM-1) was observed in 23% of the participants, only 15% was activated for self-management (PAM-4). Multiple linear regression analysis revealed six explanatory determinants of activation for self-management (P<0.2): anxiety (β: -0.35; -0.6 to -0.1), illness perception (β: -0.2; -0.3 to -0.1), body mass index (BMI) (β: -0.4; -0.7 to -0.2), age (β: -0.1; -0.3 to -0.01), Global Initiative for Chronic Obstructive Lung Disease stage (2 vs 1 β: -3.2; -5.8 to -0.5; 3 vs 1 β: -3.4; -7.1 to 0.3), and comorbidities (β: 0.8; -0.2 to 1.8), explaining 17% of the variance.
This study showed that only a minority of COPD patients is activated for self-management. Although only a limited part of the variance could be explained, anxiety, illness perception, BMI, age, disease severity, and comorbidities were identified as key determinants of activation for self-management. This knowledge enables health care professionals to identify patients at risk of inadequate self-management, which is essential to move toward targeting and tailoring of self-management interventions. Future studies are needed to understand the complex causal mechanisms toward change in self-management.</description><subject>Aged</subject><subject>Anxiety</subject><subject>Anxiety - diagnosis</subject><subject>Anxiety - psychology</subject><subject>Body mass index</subject><subject>Chronic illnesses</subject><subject>Comorbidity</subject><subject>Cross-Sectional Studies</subject><subject>Depression - diagnosis</subject><subject>Depression - psychology</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Health Behavior</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health Status</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Lung - physiopathology</subject><subject>Male</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Original Research</subject><subject>Patient Participation</subject><subject>Perception</subject><subject>Primary Health Care</subject><subject>Pulmonary Disease, Chronic Obstructive - diagnosis</subject><subject>Pulmonary Disease, Chronic Obstructive - physiopathology</subject><subject>Pulmonary Disease, Chronic Obstructive - psychology</subject><subject>Pulmonary Disease, Chronic Obstructive - therapy</subject><subject>Risk Factors</subject><subject>Secondary Care</subject><subject>Self Care</subject><subject>Self Report</subject><subject>Severity of Illness Index</subject><subject>Social Support</subject><subject>Socioeconomic factors</subject><subject>Surveys</subject><issn>1178-2005</issn><issn>1176-9106</issn><issn>1178-2005</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkt9rFDEQx4Motp6--SwLgvTBPZPNbn68COXOX1CooD6HXHZyl7KbnEm24n_fLD3rnUgIGTKf-U4yMwi9JHjZkJa_W11_XS-_ESwxYY_QOSFc1A3G3eMj-ww9S-mmGIxz8hSdNbyjDAt-jtZryBBH57XPqQq20ia7W51d8JUNsUow2HrUXm9hBJ8r56t98cJM_3J5V83pn6MnVg8JXhzOBfrx8cP31ef66vrTl9XlVW26juaaCU2AMAEM-l5sGJWskUZ3wCWzupVMt6Zt8aYlvN-UCGYoo5bIXvRaSKLpAr2_191PmxF6U14R9aD20Y06_lZBO3Xq8W6ntuFWtZIzSdoicHEQiOHnBCmr0SUDw6A9hCkpIkgjBKVlL9Drf9CbMEVfvqcaJjCWnSD8L7XVAyjnbSh5zSyqLjvMWIcpYYVa_ocqq4fRmeDBunJ_EvDmKGAHesi7FIZpbks6Bd_egyaGlCLYh2IQrObxUHN_1GE8Cv7quIAP8J95oHeDCLKW</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Korpershoek, Yjg</creator><creator>Bos-Touwen, I D</creator><creator>de Man-van Ginkel, J M</creator><creator>Lammers, J-Wj</creator><creator>Schuurmans, M J</creator><creator>Trappenburg, Jca</creator><general>Dove Medical Press Limited</general><general>Dove Medical Press Ltd</general><general>Dove Medical Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160101</creationdate><title>Determinants of activation for self-management in patients with COPD</title><author>Korpershoek, Yjg ; 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Despite scientific evidence that better disease outcomes can be achieved by enhancing self-management, many COPD patients do not respond to self-management interventions. To move toward more effective self-management interventions, knowledge of characteristics associated with activation for self-management is needed. The purpose of this study was to identify key patient and disease characteristics of activation for self-management.
An explorative cross-sectional study was conducted in primary and secondary care in patients with COPD. Data were collected through questionnaires and chart reviews. The main outcome was activation for self-management, measured with the 13-item Patient Activation Measure (PAM). Independent variables were sociodemographic variables, self-reported health status, depression, anxiety, illness perception, social support, disease severity, and comorbidities.
A total of 290 participants (age: 67.2±10.3; forced expiratory volume in 1 second predicted: 63.6±19.2) were eligible for analysis. While poor activation for self-management (PAM-1) was observed in 23% of the participants, only 15% was activated for self-management (PAM-4). Multiple linear regression analysis revealed six explanatory determinants of activation for self-management (P<0.2): anxiety (β: -0.35; -0.6 to -0.1), illness perception (β: -0.2; -0.3 to -0.1), body mass index (BMI) (β: -0.4; -0.7 to -0.2), age (β: -0.1; -0.3 to -0.01), Global Initiative for Chronic Obstructive Lung Disease stage (2 vs 1 β: -3.2; -5.8 to -0.5; 3 vs 1 β: -3.4; -7.1 to 0.3), and comorbidities (β: 0.8; -0.2 to 1.8), explaining 17% of the variance.
This study showed that only a minority of COPD patients is activated for self-management. Although only a limited part of the variance could be explained, anxiety, illness perception, BMI, age, disease severity, and comorbidities were identified as key determinants of activation for self-management. This knowledge enables health care professionals to identify patients at risk of inadequate self-management, which is essential to move toward targeting and tailoring of self-management interventions. Future studies are needed to understand the complex causal mechanisms toward change in self-management.</abstract><cop>New Zealand</cop><pub>Dove Medical Press Limited</pub><pmid>27536087</pmid><doi>10.2147/COPD.S109016</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Anxiety Anxiety - diagnosis Anxiety - psychology Body mass index Chronic illnesses Comorbidity Cross-Sectional Studies Depression - diagnosis Depression - psychology Female Forced Expiratory Volume Health Behavior Health Knowledge, Attitudes, Practice Health Status Humans Linear Models Lung - physiopathology Male Medical research Middle Aged Original Research Patient Participation Perception Primary Health Care Pulmonary Disease, Chronic Obstructive - diagnosis Pulmonary Disease, Chronic Obstructive - physiopathology Pulmonary Disease, Chronic Obstructive - psychology Pulmonary Disease, Chronic Obstructive - therapy Risk Factors Secondary Care Self Care Self Report Severity of Illness Index Social Support Socioeconomic factors Surveys |
| title | Determinants of activation for self-management in patients with COPD |
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