Zhou Weijiao, Larson Janet L, Veliz Philip T, Kitto Kanchani, Smith Sheree
School of Nursing, Peking University, Beijing, China.
School of Nursing, University of Michigan, Ann Arbor, MI, United States.
Appl Nurs Res. 2025 Aug;84:151968. doi: 10.1016/j.apnr.2025.151968. Epub 2025 May 22.
Some patients with COVID-19 experience prolonged symptoms, known as long COVID. Self-management promises to improve symptoms, but little is known about the role of self-efficacy for long COVID symptom management.
To identify distinct subgroups of patients experiencing long-term post-COVID symptom burden, and to examine the association between the identified subgroups and self-efficacy for symptom management.
A cross-sectional survey design with a convenience sampling approach. This study included 491 adults who reported experiencing long COVID symptoms. Symptoms (fatigue, dyspnea, sleep disturbance, anxiety), and self-efficacy for self-management (Self-Efficacy for Managing Chronic Disease (SEMCD) and PROMIS Self-Efficacy) were collected. Latent Profile Analysis (LPA) was used to identify profiles of adults with similar patterns of long COVID symptoms. Multinomial logistic regression was used to examine the association between self-efficacy for self-management and distinct profiles, controlling for socio-demographics and health-related characteristics. Participants' strategies to relieve COVID symptoms were collected via open-ended questions and analyzed using content analysis.
The mean age was 40.6 (SD = 14.1) years of age. We identified four profiles based on the long COVID symptom burden: "low burden," "medium burden with low depression," "medium burden with high depression," and "high burden." Participants with a higher score of SEMCD were less likely to be in Group 3 (medium burden with high depression) (RRR: 0.76, 95 % CI: 0.60-0.96, P = 0.024) and Group 4 (high burden) (RRR: 0.71, 95 % CI: 0.50-1.00, P = 0.049). Participants with a higher score on PROMIS Self-Efficacy were less likely to be in Group 3 (RRR = 0.95, 95 % CI: 0.90-1.00, P = 0.047). Participants used a range of wellness activities and self-medication strategies to self-manage symptoms.
Patients with long COVID had four distinct symptom profiles. Greater self-efficacy was associated with the profiles of less symptom burden. Self-efficacy for self-management could be an important target to consider when developing interventions to improve symptom self-management and reduce long COVID symptom burden.
一些新冠肺炎患者会经历长期症状,即所谓的“长新冠”。自我管理有望改善症状,但对于自我效能感在长新冠症状管理中的作用知之甚少。
识别经历新冠后长期症状负担的不同患者亚组,并研究所识别的亚组与症状管理自我效能感之间的关联。
采用便利抽样方法的横断面调查设计。本研究纳入了491名报告有长新冠症状的成年人。收集了症状(疲劳、呼吸困难、睡眠障碍、焦虑)以及自我管理的自我效能感(慢性病管理自我效能感(SEMCD)和患者报告结果测量信息系统自我效能感)。使用潜在剖面分析(LPA)来识别具有相似长新冠症状模式的成年人剖面。使用多项逻辑回归来研究自我管理自我效能感与不同剖面之间的关联,并控制社会人口统计学和健康相关特征。通过开放式问题收集参与者缓解新冠症状的策略,并使用内容分析进行分析。
平均年龄为40.6(标准差=14.1)岁。我们根据长新冠症状负担识别出四个剖面:“低负担”、“低抑郁的中度负担”、“高抑郁的中度负担”和“高负担”。SEMCD得分较高的参与者不太可能属于第3组(高抑郁的中度负担)(相对风险比:0.76,95%置信区间:0.60-0.96,P=0.024)和第4组(高负担)(相对风险比:0.71,95%置信区间:0.50-1.00,P=0.049)。患者报告结果测量信息系统自我效能感得分较高的参与者不太可能属于第3组(相对风险比=0.95,95%置信区间:0.90-1.00,P=0.047)。参与者使用了一系列健康活动和自我用药策略来自我管理症状。
长新冠患者有四种不同的症状剖面。更高的自我效能感与症状负担较轻的剖面相关。自我管理自我效能感可能是制定改善症状自我管理和减轻长新冠症状负担干预措施时要考虑的一个重要目标。