Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
Department of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy.
Value Health. 2022 Jul;25(7):1165-1173. doi: 10.1016/j.jval.2022.01.007. Epub 2022 Mar 23.
Self-care of chronic conditions involves both patients and their informal caregivers and therefore might be considered as a dyadic phenomenon. Nevertheless, empirical evidence supporting a dyadic construct is unavailable. This study aimed to explore the existence of a dyadic construct in self-care maintenance, monitoring, and management in patients affected by chronic conditions and their informal caregivers.
This study used a cross-sectional design. We used the Self-Care of Chronic Illness Inventory and the Caregiver Contribution to Self-Care of Chronic Illness Inventory, which measure patient self-care and informal caregivers' contribution to self-care maintenance, monitoring and management. Exploratory Structural Equation Modeling was performed to verify the existence of dyadic latent constructs in each scale in patients and informal caregivers.
A convenience sample of 493 patients and informal caregivers, with a mean age of 76.47 and 52.76 years, respectively, was studied. In the self-care maintenance scales, 2 correlated factors (r = 0.34, P < .001) were identified, indicating the presence of a dyadic second-order construct. In addition, 2 factors that were not correlated (r = 0.11, P = .064) were identified in the self-care monitoring scales, indicating the absence of a dyadic construct. Finally, we found a 3-factor model in the self-care management scales composed of both patient and caregiver items, indicating a dyadic first-order construct.
Knowing which care behaviors are dyadic in chronic conditions is important for tailoring interventions to improve self-care. Self-care maintenance and management would benefit from dyadic interventions, while self-care monitoring would not. The results of this study may illuminate future theoretical and scientific developments in dyadic care of chronic illness.
慢性病的自我护理既涉及患者本身，也涉及他们的非正式照护者，因此可以被视为一种双重现象。然而，目前尚无支持双重结构的实证证据。本研究旨在探讨慢性病患者及其非正式照护者的自我护理维持、监测和管理中是否存在双重结构。
本研究采用横断面设计。我们使用了慢性病自我护理量表和慢性病自我护理照护者贡献量表，这两个量表分别测量患者的自我护理和非正式照护者对自我护理维持、监测和管理的贡献。采用探索性结构方程模型验证了患者和非正式照护者每个量表中双重潜在结构的存在。
本研究纳入了 493 名患者和非正式照护者的便利样本，他们的平均年龄分别为 76.47 岁和 52.76 岁。在自我护理维持量表中，确定了 2 个相关因素（r=0.34，P<0.001），表明存在双重二阶结构。此外，在自我护理监测量表中，确定了 2 个不相关的因素（r=0.11，P=0.064），表明不存在双重结构。最后，我们在自我护理管理量表中发现了一个由患者和照护者项目组成的 3 因素模型，表明存在双重一阶结构。
了解慢性病中哪些护理行为是双重的，对于量身定制干预措施以改善自我护理非常重要。自我护理维持和管理将受益于双重干预，而自我护理监测则不然。本研究的结果可能为慢性病双重护理的未来理论和科学发展提供启示。
