Self-management support needs of patients with chronic illness: do needs for support differ according to the course of illness?

Patient Educ Couns. 2013 Dec;93(3):626-32. doi: 10.1016/j.pec.2013.08.021. Epub 2013 Aug 29.

Abstract

Objective: To determine whether chronically ill patients' needs for self-management support depend on their course of illness.

Methods: Cross-sectional and longitudinal linear regression analyses were conducted using data from 1300 patients with chronic disease(s) who participated in a nationwide Dutch panel-study. Self-management support needs were assessed by the Patient Assessment of Self-management Tasks questionnaire (PAST). Course of illness was operationalized as: illness duration, patients' perception of the course of illness and changes in self-rated general health (RAND-36).

Results: Self-management support needs are not related to illness duration. Patients who perceive their illness as episodic and/or progressively deteriorating have greater self-management support needs than patients who perceive their illness as stable. Deterioration of self-rated health is related to increased support needs. The effect of the course of illness on support needs depends on the type of self-management activities.

Conclusion: How chronically ill patients perceive the course of illness and actual changes in self-rated health are predictive for their need for support for self-management activities. Illness duration is not.

Practice implications: Helping patients to self-manage should not be confined to the first years after diagnosis. Healthcare providers should be alert to patients' own perceptions of their course of illness and health status.

Keywords: Chronic illness; Course of illness; Patients; Self-management; Support need.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / therapy*
  • Cross-Sectional Studies
  • Female
  • Health Services Needs and Demand
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • Netherlands
  • Patients / psychology*
  • Quality of Health Care / organization & administration
  • Regression Analysis
  • Self Care* / methods
  • Self Report
  • Social Support*
  • Surveys and Questionnaires
  • Young Adult