Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Public Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea.
Psychol Health Med. 2021 Sep;26(8):1031-1043. doi: 10.1080/13548506.2020.1838585. Epub 2020 Oct 23.
Self-management strategies are essential for improving prognosis in chronic illnesses. This study aimed to investigate the association between comorbidity and self-management strategies. A total of 700 patients with one or more chronic diseases including diabetes, dyslipidemia, hypertension, osteoporosis, chronic lung disease, chronic kidney disease and arthritis were enrolled. A questionnaire including the Smart Management Strategy for Health Assessment Tool Short Form (SAT), the Short Form-12, the McGill Quality of Life questionnaire, and the Patient Health Questionnaire-9 was administered to participants. The trend of each SAT according to number of comorbidities was evaluated, and the difference in quality of life and depression according to self-management strategies was examined in the model classified by the number of diseases. Self-management strategy scores tended to decrease as the number of comorbidities increased from one to four (p-value: 0.001 to 0.008). Regardless of the number of comorbidities, the MQOL score was higher in the good self-management strategy group (p: <0.001 to 0.016). The prevalence of mild depression was higher in patients with low self-management strategy, but the differences were not significant. Based on these findings, self-management strategies should be evaluated multidimensionally, and patients should be encouraged to develop effective self-management strategies to manage multiple chronic diseases.
自我管理策略对于改善慢性病的预后至关重要。本研究旨在探讨共病与自我管理策略之间的关系。共纳入 700 名患有一种或多种慢性病（包括糖尿病、血脂异常、高血压、骨质疏松症、慢性肺病、慢性肾脏病和关节炎）的患者。向参与者发放了包括 Smart Management Strategy for Health Assessment Tool Short Form (SAT)、Short Form-12、McGill 生活质量问卷和患者健康问卷-9 的问卷。评估了根据共病数量的每个 SAT 的趋势，并根据疾病数量分类的模型检查了自我管理策略与生活质量和抑郁之间的差异。自我管理策略评分随着共病数量从一到四的增加而呈下降趋势（p 值：0.001 至 0.008）。无论共病数量如何，良好自我管理策略组的 MQOL 评分较高（p：<0.001 至 0.016）。低自我管理策略组的轻度抑郁患病率较高，但差异无统计学意义。基于这些发现，应从多个维度评估自我管理策略，并鼓励患者制定有效的自我管理策略来管理多种慢性疾病。
