St. Mary's Research Centre, Hayes Pavilion, 3830 Avenue Lacombe, Suite 4720, H3T 1M5, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pin. Avenue, H3A 1A2, Montreal, Quebec, Canada.
St. Mary's Research Centre, Hayes Pavilion, 3830 Avenue Lacombe, Suite 4720, H3T 1M5, Montreal, Quebec, Canada; Ingram School of Nursing, McGill University, McGill University, 680 Sherbrooke Street West, Suite 1800, H3A 2M7, Montreal, Quebec, Canada.
Patient Educ Couns. 2019 Mar;102(3):571-577. doi: 10.1016/j.pec.2018.10.026. Epub 2018 Nov 3.
To examine: 1) whether patient characteristics predict perceived self-management support (usefulness of information and collaborative care planning) by primary care providers after six months, and 2) the association between perceived self-management support and patient activation at 6 months METHODS: We conducted a secondary analysis among 120 primary care patients aged 40 and over with a chronic physical condition and comorbid depressive symptoms who participated in a randomized controlled trial of a coaching intervention for depression self-management. Activation was measured at baseline (T0) and 6 months (T1). Self-management support was captured at T1 for physical and mood problems.
The sample of analysis was 120 patients who completed all relevant measures. At T1, the perceived usefulness of information for mood self-management was independently associated with activation. More severe depressive symptoms at T0 predicted lower perceived usefulness of chronic condition self-management information at T1. Lower T0 mental health-related quality of life predicted lower perceived usefulness of mood self-management information at T1.
Perceived informational support for mood self-management may contribute to increased activation. Patients with more severe mental health symptoms or impairment perceive that they receive less useful self-management information from their care team.
Care teams should determine whether patients with mood problems need greater self-management support.
检验：1）患者特征是否能预测初级保健提供者在六个月后对自我管理支持（信息有用性和协作护理计划）的感知，2）感知到的自我管理支持与患者在 6 个月时的积极性之间的关联。
我们对 120 名年龄在 40 岁及以上、患有慢性躯体疾病和共病抑郁症状的初级保健患者进行了二次分析，这些患者参加了一项针对抑郁自我管理的辅导干预的随机对照试验。在基线（T0）和 6 个月（T1）时测量激活情况。在 T1 时，对躯体和情绪问题的自我管理支持进行了评估。
分析的样本是 120 名完成了所有相关测量的患者。在 T1 时，信息对情绪自我管理的有用性感知与积极性独立相关。T0 时更严重的抑郁症状预测了 T1 时对慢性疾病自我管理信息有用性感知降低。T0 时心理健康相关生活质量较低预测了 T1 时对情绪自我管理信息有用性感知较低。
对情绪自我管理的感知信息支持可能有助于提高积极性。心理健康症状或障碍更严重的患者认为他们从护理团队那里获得的自我管理信息用处不大。
护理团队应确定是否有情绪问题的患者需要更多的自我管理支持。
