van Houtum Lieke, Rijken Mieke, Groenewegen Peter
Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN, Utrecht, Netherlands.
Department of Sociology and Department of Human Geography, Utrecht University, P.O. Box 80140, 3508 TC, Utrecht, Netherlands.
BMC Public Health. 2015 Oct 1;15:1000. doi: 10.1186/s12889-015-2303-3.
Being chronically ill is a continuous process of balancing the demands of the illness and the demands of everyday life. Understanding how everyday life affects self-management might help to provide better professional support. However, little attention has been paid to the influence of everyday life on self-management. The purpose of this study is to examine to what extent problems in everyday life interfere with the self-management behaviour of people with chronic illness, i.e. their ability to manage their illness.
To estimate the effects of having everyday problems on self-management, cross-sectional linear regression analyses with propensity score matching were conducted. Data was used from 1731 patients with chronic disease(s) who participated in a nationwide Dutch panel-study.
One third of people with chronic illness encounter basic (e.g. financial, housing, employment) or social (e.g. partner, children, sexual or leisure) problems in their daily life. Younger people, people with poor health and people with physical limitations are more likely to have everyday problems. Experiencing basic problems is related to less active coping behaviour, while experiencing social problems is related to lower levels of symptom management and less active coping behaviour.
The extent of everyday problems interfering with self-management of people with chronic illness depends on the type of everyday problems encountered, as well as on the type of self-management activities at stake.
Healthcare providers should pay attention to the life context of people with chronic illness during consultations, as patients' ability to manage their illness is related to it.
慢性病患者处于一个持续平衡疾病需求与日常生活需求的过程。了解日常生活如何影响自我管理可能有助于提供更好的专业支持。然而,日常生活对自我管理的影响却很少受到关注。本研究的目的是探讨日常生活中的问题在多大程度上干扰慢性病患者的自我管理行为,即他们管理疾病的能力。
为了评估日常生活问题对自我管理的影响,进行了倾向得分匹配的横断面线性回归分析。数据来自1731名参与荷兰全国性小组研究的慢性病患者。
三分之一的慢性病患者在日常生活中遇到基本(如财务、住房、就业)或社会(如伴侣、子女、性或休闲)问题。年轻人、健康状况差的人和有身体限制的人更有可能遇到日常生活问题。遇到基本问题与较少的积极应对行为有关,而遇到社会问题与较低的症状管理水平和较少的积极应对行为有关。
日常生活问题干扰慢性病患者自我管理的程度取决于所遇到的日常生活问题的类型,以及所涉及的自我管理活动的类型。
医疗保健提供者在会诊期间应关注慢性病患者的生活背景,因为患者管理疾病的能力与之相关。