Data from: Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study

A substantial proportion of chronic disease patients do not respond to self-management interventions, which suggests that one size interventions do not fit all, demanding more tailored interventions. To compose more individualized strategies, we aim to increase our understanding of characteristics associated with patient activation for self-management and to evaluate whether these are disease-transcending. A cross-sectional survey study was conducted in primary and secondary care in patients with type-2 Diabetes Mellitus (DM-II), Chronic Obstructive Pulmonary Disease (COPD), Chronic Heart Failure (CHF) and Chronic Renal Disease (CRD). Using multiple linear regression analysis, we analyzed associations between self-management activation (13-item Patient Activation Measure; PAM-13) and a wide range of socio-demographic, clinical, and psychosocial determinants. Furthermore, we assessed whether the associations between the determinants and the PAM were disease-transcending by testing whether disease was an effect modifier. In addition, we identified determinants associated with low activation for self-management using logistic regression analysis. We included 1154 patients (53% response rate); 422 DM-II patients, 290 COPD patients, 223 HF patients and 219 CRD patients. Mean age was 69.6±10.9. Multiple linear regression analysis revealed 9 explanatory determinants of activation for self-management: age, BMI, educational level, financial distress, physical health status, depression, illness perception, social support and underlying disease, explaining a variance of 16.3%. All associations, except for social support, were disease transcending. This study explored factors associated with varying levels of activation for self-management. These results are a first step in supporting clinicians and researchers to identify subpopulations of chronic disease patients less likely to be engaged in self-management. Increased scientific efforts are needed to explain the greater part of the factors that contribute to the complex nature of patient activation for self-management.相当比例的慢性病患者对自我管理干预措施无应答，这表明“一刀切”的干预方案无法适用于所有患者，因此亟需制定更具针对性的干预措施。为制定更为个体化的干预策略，本研究旨在加深对与慢性病患者自我管理激活相关特征的认知，并评估这些特征是否具有跨疾病普遍性。本研究针对2型糖尿病（DM-II）、慢性阻塞性肺疾病（COPD）、慢性心力衰竭（CHF）及慢性肾脏病（CRD）患者，在基层与二级医疗保健机构中开展了横断面调查。本研究采用多元线性回归分析，探究了自我管理激活水平（13条目患者激活度量表，PAM-13）与一系列社会人口学、临床及社会心理学影响因素之间的关联。此外，本研究通过检验疾病是否为效应修饰因子，评估了上述影响因素与PAM评分之间的关联是否具有跨疾病普遍性。此外，本研究还采用逻辑回归分析，筛选出了与自我管理激活水平低下相关的影响因素。本研究共纳入1154例患者（应答率53%），其中2型糖尿病患者422例、慢性阻塞性肺疾病患者290例、慢性心力衰竭患者223例及慢性肾脏病患者219例。受试者平均年龄为69.6±10.9岁。多元线性回归分析结果显示，共9个因素可解释自我管理激活水平的变异：年龄、体质量指数（BMI）、受教育水平、经济窘迫状况、身体健康状态、抑郁症状、疾病感知、社会支持及基础疾病类型，其解释方差为16.3%。除社会支持外，其余所有影响因素与自我管理激活水平的关联均具有跨疾病普遍性。本研究探究了与自我管理激活水平异质性相关的各类影响因素。本研究结果可为临床医师与科研人员识别自我管理参与度较低的慢性病患者亚群提供初步参考。未来仍需开展更多科学研究，以阐明影响慢性病患者自我管理激活这一复杂过程的更多相关因素。