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

van Houtum L, Rijken M, Heijmans M, Groenewegen P. 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. Available at: http://www.sciencedirect.com/science/article/pii/S0738399113003467

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.