Thorpe C T, DeVellis R F, Blalock S J, Hogan S L, Lewis M A, DeVellis B M
Health Innovation Program, Department of Population Health Sciences, University of Wisconsin, E5/724 CSC, 600 Highland Avenue, Madison, WI 53792-7685, USA.
Rheumatology (Oxford). 2008 Jun;47(6):881-6. doi: 10.1093/rheumatology/ken126. Epub 2008 Apr 9.
To characterize patient perceptions, related to eight self-management behaviours relevant for adults with ANCA-associated small vessel vasculitis (ANCA-SVV), and to determine if these perceptions were associated with performance of each behaviour.
Adults with ANCA-SVV (n = 202) completed a self-administered questionnaire that assessed eight self-management behaviours (adherence to recommendations for medication, health service use, diet, exercise, infection avoidance and symptom monitoring; prompt reporting of symptoms and side effects; and adjusting activities in response to symptoms), perceptions about these behaviours, socio-demographics, clinical factors and social desirability bias. Descriptive statistics were generated to characterize patients' perceptions about difficulty of, importance of, and specific barriers to performing each behaviour. Regression analyses explored whether these variables were associated with performing each behaviour, controlling for potential confounders.
With few exceptions, higher perceived importance and lower perceived difficulty of each behaviour were associated with more frequent performance of the behaviour. For each behaviour, several specific barriers were frequently endorsed by patients and a number of these were associated with lower levels of self-management.
This study reveals that patient perceptions about the illness and its treatment influence ANCA-SVV self-management. Perceived barriers to medication, health services, diet and exercise adherence were similar to those in other illnesses. This study also provides insight into barriers experienced by patients in performing behaviours (infection avoidance, symptom monitoring, reporting symptoms and side-effects and adjusting activities) not often previously studied. How the identification of these barriers can help inform future interventions for ANCA-SVV patients is to be discussed.
描述与抗中性粒细胞胞浆抗体相关的小血管炎（ANCA - SVV）成人患者的八种自我管理行为相关的患者认知，并确定这些认知是否与每种行为的表现相关。
患有ANCA - SVV的成人患者（n = 202）完成了一份自我管理问卷，该问卷评估了八种自我管理行为（遵守药物治疗建议、使用医疗服务、饮食、运动、避免感染和症状监测；及时报告症状和副作用；以及根据症状调整活动）、对这些行为的认知、社会人口统计学、临床因素和社会期望偏差。生成描述性统计数据以描述患者对每种行为的难度、重要性和具体障碍的认知。回归分析探讨了这些变量是否与每种行为的表现相关，并控制了潜在的混杂因素。
除少数例外，每种行为的较高认知重要性和较低认知难度与更频繁的行为表现相关。对于每种行为，患者经常认可几种具体障碍，其中一些与较低水平的自我管理相关。
本研究表明，患者对疾病及其治疗的认知会影响ANCA - SVV的自我管理。在药物治疗、医疗服务、饮食和运动依从性方面的认知障碍与其他疾病中的类似。本研究还深入了解了患者在执行以前较少研究的行为（避免感染、症状监测、报告症状和副作用以及调整活动）时所遇到的障碍。将讨论识别这些障碍如何有助于为未来针对ANCA - SVV患者的干预措施提供信息。
