1 University of Florida, Gainesville, FL, USA.
2 Department of State Health Services, Austin, TX, USA.
Med Care Res Rev. 2019 Aug;76(4):444-461. doi: 10.1177/1077558717709419. Epub 2017 May 15.
Patient activation, the perceived capacity to manage one's health, is positively associated with better health outcomes and lower costs. Underlying characteristics influencing patient activation are not completely understood leading to gaps in intervention strategies designed to improve patient activation. We suggest that variability in executive functioning influences patient activation and ultimately has an impact on health outcomes. To examine this hypothesis, 440 chronically ill Medicaid enrollees completed measures of executive functioning, patient activation, and health-related quality of life. Mediation analyses revealed that executive functioning: (a) directly affected patient activation and mental health-related quality of life, (b) indirectly affected mental health-related quality of life through patient activation, and (c) was unrelated to physical health-related quality of life. These data indicate that further study of the relationships among neurocognitive processes, patient activation, and health-related quality of life is needed and reinforces previous work demonstrating the association between patient activation and self-reported outcomes.
患者激活，即感知管理自身健康的能力，与更好的健康结果和更低的成本呈正相关。影响患者激活的潜在特征尚不完全清楚，这导致旨在提高患者激活的干预策略存在差距。我们认为，执行功能的变异性会影响患者的激活，最终对健康结果产生影响。为了检验这一假设，440 名患有慢性病的医疗补助参保者完成了执行功能、患者激活和与健康相关的生活质量的测量。中介分析表明，执行功能：（a）直接影响患者的激活和心理健康相关的生活质量，（b）通过患者的激活间接影响心理健康相关的生活质量，（c）与身体健康相关的生活质量无关。这些数据表明，需要进一步研究神经认知过程、患者激活和与健康相关的生活质量之间的关系，并加强以前的工作，证明患者激活与自我报告的结果之间存在关联。
