Ahn, Yang Heui
(Department of Nursing, Yonsei University Wonju College of Medicine)
,
Kim, Bong Jeong
(Department of Nursing, Cheongju University)
,
Ham, Ok Kyung
(Department of Nursing, Inha University)
,
Kim, Seong Hoon
(Department of Rehabilitation, Yonsei University Wonju College of Medicine)
Purpose: The purpose of this study was to survey patient activation for self-management and to identify factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. Methods: Cross-sectional study design was used. Survey data were collected fr...
Purpose: The purpose of this study was to survey patient activation for self-management and to identify factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. Methods: Cross-sectional study design was used. Survey data were collected from 270 community residents with osteoarthritis through direct interviews. Studied factors included patient activation, joint pain, physical function, depression, and general characteristics. Data were analyzed using chi-squared test, t-test and multivariate logistic regression analysis. Results: The participants' mean score of patient activation was $56.0{\pm}16.61$. The mean score of each factor was $10.6{\pm}5.89$ for joint pain, $5.5{\pm}3.56$ for physical function, and $19.3{\pm}10.01$ for depression. The patient activation level was significantly associated with depression and general characteristics such as education, religion, comorbid hypertension, and use of medical clinics (p<.05). Conclusion: The findings suggest that depression, education, religion, comorbid hypertension, and use of medical clinics may be important factors to be considered when developing programs of patient activation for self-management. This is the first study that measured patient activation, and further studies are suggested to find factors associated with patient activation for self-management among community residents with other chronic diseases.
Purpose: The purpose of this study was to survey patient activation for self-management and to identify factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. Methods: Cross-sectional study design was used. Survey data were collected from 270 community residents with osteoarthritis through direct interviews. Studied factors included patient activation, joint pain, physical function, depression, and general characteristics. Data were analyzed using chi-squared test, t-test and multivariate logistic regression analysis. Results: The participants' mean score of patient activation was $56.0{\pm}16.61$. The mean score of each factor was $10.6{\pm}5.89$ for joint pain, $5.5{\pm}3.56$ for physical function, and $19.3{\pm}10.01$ for depression. The patient activation level was significantly associated with depression and general characteristics such as education, religion, comorbid hypertension, and use of medical clinics (p<.05). Conclusion: The findings suggest that depression, education, religion, comorbid hypertension, and use of medical clinics may be important factors to be considered when developing programs of patient activation for self-management. This is the first study that measured patient activation, and further studies are suggested to find factors associated with patient activation for self-management among community residents with other chronic diseases.
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문제 정의
Therefore, identifying factors associated with patient activation will be helpful evidence in designing intervention strategies to stimulate increases in activation among patients with chronic conditions. The purpose of this study was to describe patient activation for SM and to identify factors associated with patient activation for SM among community residents with osteoarthritis.
제안 방법
Dep ression was measured using the Korean Center for Epidemiologic Studies Depression Scale (K-CES-D), which was translated and tested for reliability and validity by Cho and Kim[21]. The 20 items are rated on a 4-point Likert scale (0=almost none, 1=1 to 2 days per week, 2=3 to 4 days per week, and 3=5 to 7 days per week) as a measure of frequency of symptoms experienced during the past week. Three items with negative meanings were reverse coded for statistical analysis.
Some limitations of this study should be noted. First, the study was cross-sectional., thus causal relationship between variables is not clear indicating a need for experimental or longitudinal studies to examine changes in relationships among variables over time.
대상 데이터
A cross-sectional survey design was employed. A convenience sample of 270 osteoarthritis patients was recruited from the three Community Health Posts located in W city, Korea. Using G*Power 3.
이론/모형
patient activation was measured using the Korean version of the 13-item Patient Activation Measure (PAM 13-K) which is a scale assessing patients’ knowledge, skills, and confidence for self-management of a chronic disease[6].
A cross-sectional survey design was employed. A convenience sample of 270 osteoarthritis patients was recruited from the three Community Health Posts located in W city, Korea.
Joint pain was measured using the Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), a specific measure assessing pain, stiffness, and physical function in patient with osteoarthritis in the hip or knee[18]. In the current study, the 7 items of the K-WOMAC were selected to measure self-reported joint pain and stiffness.
physical function was measured using the Korean version of 8-item Stanford Health Assessment Questionnaire Disability Scale (HAQDS) to assess arthritis health outcomes[20]. It was translated into Korean and a blind back-translation was performed by independent bilingual nurse scholars.
Dep ression was measured using the Korean Center for Epidemiologic Studies Depression Scale (K-CES-D), which was translated and tested for reliability and validity by Cho and Kim[21]. The 20 items are rated on a 4-point Likert scale (0=almost none, 1=1 to 2 days per week, 2=3 to 4 days per week, and 3=5 to 7 days per week) as a measure of frequency of symptoms experienced during the past week.
성능/효과
The results show that the mean score for patient activation was 56.0±16.61, which is similar to that of patients (average age of 61.9 years) with chronic conditions (56.8±10.00)[8], but lower than that of patients with diabetes (mean=62.7)[23] (average age of 62 years) and chronic conditions (mean=64.2) (age of 18 years over)[12].
The current study investigated factors associated with patient activation for SM among community residents with OA using survey data. The study results revealed that depression and general characteristics such as education, religion, comorbid hypertension, and use of medical clinics were significantly associated with patient activation for SM. These findings provide insights and valuable information in assessing and designing effective intervention programs, and these significant variables could be employed in targeting population intervention, and in developing messages tailored to the characteristics of the clients with OA.
후속연구
As the presence of comorbidities within the osteoarthritis patient population negatively impacts both physical functioning and pain, more aggressive teaching of self-management skills is needed for osteoarthritis patients with comorbidities[12]. Further study is required to ascertain the relationship between patient activation for SM and comorbidities in this population. And the results of this study show that people using medical clinics at least once or more for treatment of their symptomatic OA during past 6 months, had lower patient activation.
This result may indicate that patient activation level may not directly influence joint pain and physical function, but influence them indirectly through health behaviors[30]. Further research is needed to understand the relationship between patient activation level and health status such as joint pain and physical function for these patients.
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