Department of Family Medicine, Maastricht University, CAPHRI Care and Public Health Research Institute, Maastricht, the Netherlands.
Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Int J Chron Obstruct Pulmon Dis. 2020 Jun 19;15:1415-1423. doi: 10.2147/COPD.S224943. eCollection 2020.
Self-management (SM) is a core component of well-being and perceived health for patients with chronic obstructive pulmonary disease (COPD). Most theories on SM share that self-efficacy, illness-perception and coping are determinants of SM behavior. Optimal support to improve SM should be tailored to the individual patient's level of these determinants as SM abilities vary between patients. To tailor SM support, it is therefore necessary to assess the scores on these determinants. Unfortunately, no such instrument exists for clinical use. Therefore, the first goal of this study was to verify presumed correlations between SM and the determinants thereof. The second goal was to develop an instrument to assess the SM abilities.
In this cross-sectional, observational study, COPD patients completed the General Self-Efficacy Scale (GSES), Brief Illness Perception Questionnaire (B-IPQ) and the Utrecht Proactive Coping Competence measure (UPCC) as well as the Self-Management Ability Scale (SMAS-30). Correlations between the questionnaires were assessed and a principal component analysis (PCA) was performed to identify the best-fitting items in the three independent variables related to SM. These items were used to create an instrument to assess SM abilities.
Hundred COPD patients (58 males, 41 females, 1 unknown) were included. The correlation between SM and self-efficacy, illness perception on concerns and proactive coping was moderate and significant (r=0.318, p<0.01; r=-.230, p<0.05; r=.426, p<0.01, respectively). PCA identified six UPCC items and nine GSES items that met the predefined criteria. These items were supplemented with the B-IPQ concerns item to establish the new instrument to assess SM abilities.
自我管理(SM)是慢性阻塞性肺疾病(COPD)患者幸福感和健康感知的核心组成部分。大多数关于 SM 的理论都认为自我效能、疾病认知和应对方式是 SM 行为的决定因素。为了提高 SM,最佳支持应该根据患者的这些决定因素水平进行定制,因为患者之间的 SM 能力存在差异。因此,定制 SM 支持需要评估这些决定因素的得分。不幸的是,目前还没有用于临床的此类工具。因此,本研究的第一个目标是验证 SM 与这些决定因素之间的假定相关性。第二个目标是开发一种评估 SM 能力的工具。
在这项横断面观察性研究中,COPD 患者完成了一般自我效能感量表(GSES)、简要疾病认知问卷(B-IPQ)和乌得勒支积极应对能力量表(UPCC)以及自我管理能力量表(SMAS-30)。评估了问卷之间的相关性,并进行了主成分分析(PCA),以确定与 SM 相关的三个独立变量中最适合的项目。这些项目被用于创建一种评估 SM 能力的工具。
共纳入 100 例 COPD 患者(58 名男性,41 名女性,1 名未知)。SM 与自我效能、关注和积极应对的疾病认知之间存在中度且显著的相关性(r=0.318,p<0.01;r=-.230,p<0.05;r=.426,p<0.01,分别)。PCA 确定了满足预设标准的 9 项 GSES 项目和 6 项 UPCC 项目。这些项目与 B-IPQ 关注项目相结合,构成了评估 SM 能力的新工具。