Factors associated with patient activation in inflammatory arthritis: a multisite cross-sectional study

Abstract Objectives Patient activation covers the skills, abilities and behaviour that impact how able and willing someone is to take an active role in self-managing their health. This study explored clinical and psychosocial factors associated with patient activation in rheumatology patients. Methods This was a cross-sectional study using postal survey methods. Participants with inflammatory rheumatic conditions were from six rheumatology centres in England. Patient activation was captured using the Patient Activation Measure (PAM). Twenty-nine explanatory factors were tested for potential association with patient activation in univariable and multivariable analyses. In preliminary multivariable analyses, factors found to have an association with patient activation at a P < 0.1 level were entered into the final multivariable model. Those that remained significant at a P < 0.05 level were considered associated with patient activation. Results The sample comprised 251 participants (74% female) with a mean age of 59.31 years (s.d. 12.69), disease duration of 14.48 years (s.d. 12.52) and a PAM score of 58.3 (s.d. 11.46). Of the 29 candidate factors, 25 were entered into a preliminary multivariable analysis. In the final multivariable analysis, four factors (self-efficacy, the illness belief that treatment will control participants’ condition and two dimensions of health literacy) were significantly associated with patient activation. This final model accounted for 40.4% of the variance in PAM scores [F(4, 246) = 41.66, P < 0.001]. Conclusions Patient activation is important in managing rheumatic conditions. Our data confirm that self-efficacy and health literacy are particular targets for patient activation interventions.

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AB0898-HPR WICH FACTORS ARE RELATED TO PAINFUL EXPERIENCE IN PATIENTS AFFECTED BY CHRONIC INFLAMMATORY RHEUMATIC DISEASE DURING THE COVID-19 PANDEMIC?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4073 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1472.2-1472

Author(s):

T. El Joumani ◽

H. Rkain ◽

T. Fatima Zahrae ◽

H. Kenza ◽

R. Abouqal ◽

...

Keyword(s):

Psychological Impact ◽

Multivariable Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Quality Of Sleep ◽

Cross Sectional ◽

Therapeutic Adherence ◽

Factors Associated ◽

Painful Experience

Objectives:To evaluate the effect of containment, during the Covid-19 pandemic, on the pain of patients with CIRD, and to analyze the factors associated with the experience of pain.Methods:A cross-sectional study was conducted among patients with rheumatic diseases using a questionnaire providing information on patients and disease characteristics. Impact of COVID-19 on This is a cross-sectional study that consecutively includedPatients were asked to assess the global pain which they had experienced before and during the containment period, using a single Visual Analogue Scale (VAS) ranging from 0 (no pain) to 10 (greatest pain).Statistical Analysis System IBM SPSS Statistics V20.0.0 was used to analyze the study data.We performed univariate then multivariate analysis to search any related factors to pain perception during to quarantines. Qualitative values were analyzed by the chi2 test. Quantitative values were analyzed by the Student test when the measures were normally distributed or by nonparametric test (Mann–Whitney U) when the measures were not normally distributed (Kolmogorov–Smirnov test was used to test normality).Results:Among the 350 patients who answered to the questionnaire online, rheumatoid arthritis represented 62.3%, spondyloarthropathy 34.3% and undifferentiated CIRD 3.4%.Pain experience caused by the CIRD during the containment was reported by 79.1% of patients.The level of pain, using the VAS of Pain increased significantly during the COVID-19 pandemic (4,6 ± 2,8 and 5,4 ± 3 before and during the containment; p<0.001).In multivariate analysis, the factors implicated in pain were the negative impact of Coronavirus on access to rheumatologic care, discontinuation of therapeutic adherence, the disturbed quality of sleep and the negative psychological impact (table 1).Table 1: Summarize multivariable analysis of factors associated with painful experience related to CIRD during containement.Table 1.Multivariable analysis of factors associated with painful experience related to CIRD during containementPImpact on monitoring0.05Impact on therapeutic adherence<0.001Quality of sleep disturbed0.001Negative psychological impact0.02Conclusion:This survey showed the that the COVID-19 pandemic have incresed painful experience in CIRD patients. Factors influencing painful experience should be taken into account to help patients to cope with their chronic rheumatism and this global health crisis.Disclosure of Interests:None declared

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Factors associated with physical inactivity among female and male rural adolescents in Borneo – a cross-sectional study

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2013-0319 ◽

2014 ◽

Vol 26 (3) ◽

pp. 447-453 ◽

Cited By ~ 3

Author(s):

Whye Lian Cheah ◽

Hazmi Helmy ◽

Ching Thon Chang

Keyword(s):

Self Efficacy ◽

Physical Inactivity ◽

Cross Sectional Study ◽

Perceived Barriers ◽

Anthropometric Measurement ◽

Rural Adolescents ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Significant Difference

Abstract Rural communities have shown marked increase in metabolic syndrome among young people, with physical inactivity as one of the main contributing factors. This study aimed to determine factors associated with physical inactivity among male and female rural adolescents in a sample of schools in Malaysia. A cross-sectional study was conducted among 145 students aged 13–15 years. Data on socio-demographic, health-related, and psychosocial factors (perceived barriers, self-efficacy, social influences) were collected using a self-administered questionnaire. Anthropometric measurement was taken to generate body mass index (BMI)-for-age, while physical activity (PA) level was assessed using pedometers. The mean steps per day was 6251.37 (SD=3085.31) with males reported as being more active. About 27% of the respondents were either overweight or obese, with more females in this group. There was no significant difference in steps among males and females (p=0.212), and nutritional status (BMI-for-age) (p=0.439). Females consistently scored higher in most items under perceived barriers, but had significantly lower scores in self-efficacy’s items. Males were more influenced by peers in terms of PA (p<0.001) and were more satisfied with their body parts (p=0.047). A significantly higher body size discrepancy score was found among females (p=0.034, CI –0.639, –0.026). PA level was low and almost one-third of the respondents were overweight and obese. Female students faced more barriers and had lower self-efficacy with regards PA. Based on the findings, it is recommended that interventions focus on reducing barriers while increasing support for PA. This is particularly important in improving the health status of the youth, especially among the females.

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How self-stigma affects patient activation in persons with type 2 diabetes: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-034757 ◽

2020 ◽

Vol 10 (5) ◽

pp. e034757

Author(s):

Asuka Kato ◽

Yuko Fujimaki ◽

Shin Fujimori ◽

Akihiro Isogawa ◽

Yukiko Onishi ◽

...

Keyword(s):

Self Efficacy ◽

Goodness Of Fit ◽

Patient Activation ◽

Self Care ◽

Self Esteem ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Fit Index

ObjectivesSelf-stigma is associated with lower patient activation levels for self-care in persons with type 2 diabetes mellitus (T2DM). However, the causal pathway linking self-stigma with patient activation for self-care has not been shown. In order to determine how self-stigma affects patient activation for self-care, we tested a two-path hypothetical model both directly and as mediated by self-esteem and self-efficacy.DesignA cross-sectional study.SettingTwo university hospitals, one general hospital and one clinic in Japan.ParticipantsT2DM outpatients receiving treatment (n=209) completed a self-administered questionnaire comprising the Self-Stigma Scale, Patient Activation Measure, Rosenberg Self-Esteem Scale, General Self-Efficacy Scale, Patient Health Questionnaire, haemoglobin A1c test, age, sex and body mass index.Primary and secondary outcome measuresSelf-stigma levels were measured by using the Self-Stigma Scale. Patient activation levels were measured by the Patient Activation Measure.ResultsPath analysis showed a strong relationship between self-stigma and patient activation (χ2=27.55, p=0.120; goodness-of-fit index=0.97; adjusted goodness-of-fit index=0.94; comparative fit index=0.98; root mean square error of approximation=0.04). Self-stigma had a direct effect on patient activation (β=−0.20; p=0.002). Indirectly, self-stigma affected patient activation along two paths (β=0.31; p<0.001) by reducing self-esteem (β=−0.22; p<0.001) and self-efficacy (β=−0.36; p<0.001).ConclusionsDue to the cross-sectional design of the study, longitudinal changes between all the variables cannot be established. However, the findings indicate that self-stigma affected patient activation for self-care, both directly and as mediated by self-esteem and self-efficacy. Interventions that increase self-esteem and self-efficacy may decrease self-stigma in patients with T2DM, thus increasing patient activation for self-care.

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Factors associated with patient activation in an Australian population with comorbid diabetes and chronic kidney disease: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-017695 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017695 ◽

Cited By ~ 9

Author(s):

Edward Zimbudzi ◽

Clement Lo ◽

Sanjeeva Ranasinha ◽

Gregory R Fulcher ◽

Stephen Jan ◽

...

Keyword(s):

Kidney Disease ◽

Patient Activation ◽

Cross Sectional Study ◽

Problem List ◽

Sectional Study ◽

Cross Sectional ◽

Factors Associated ◽

Lower Activation ◽

Patients With Diabetes ◽

Reported Health

ObjectiveTo evaluate the extent of patient activation and factors associated with activation in adults with comorbid diabetes and chronic kidney disease (CKD).DesignA cross-sectional study.SettingRenal/diabetes clinics of four tertiary hospitals across the two largest states of Australia.Study populationAdult patients (over 18 years) with comorbid diabetes and CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2).Main outcome measuresPatients completed the Patient Activation Measure, the Kidney Disease Quality of Life and demographic and clinical data survey from January to December 2014. Factors associated with patient activation were examined using χ2or t-tests and linear regression.ResultsThree hundred and five patients with median age of 68 (IQR 14.8) years were studied. They were evenly distributed across socioeconomic groups, stage of kidney disease and duration of diabetes but not gender. Approximately 46% reported low activation. In patients with low activation, the symptom/problem list, burden of kidney disease subscale and mental composite subscale scores were all significantly lower (all p<0.05). On multivariable analysis, factors associated with lower activation for all patients were older age, worse self-reported health in the burden of kidney disease subscale and lower self-care scores. Additionally, in men, worse self-reported health in the mental composite subscale was associated with lower activation and in women, worse self-reported health scores in the symptom problem list and greater renal impairment were associated with lower activation.ConclusionFindings from this study suggest that levels of activation are low in patients with diabetes and CKD. Older age and worse self-reported health were associated with lower activation. This data may serve as the basis for the development of interventions needed to enhance activation and outcomes for patients with diabetes and CKD.

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Self-efficacy and ability to read as factors associated with antiretroviral therapy adherence in an HIV-infected population

International Journal of STD & AIDS ◽

10.1177/0956462418776073 ◽

2018 ◽

Vol 29 (12) ◽

pp. 1154-1164 ◽

Cited By ~ 2

Author(s):

Mark S Dworkin ◽

Apurba Chakraborty ◽

Diana Zychowski ◽

Geri Donenberg ◽

Richard Novak ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Self Efficacy ◽

Cross Sectional Study ◽

Specific Knowledge ◽

Cross Sectional ◽

Antiretroviral Adherence ◽

Factors Associated ◽

The Past ◽

Antiretroviral Therapy Adherence ◽

Multivariable Analyses

Determining the barriers and facilitators of antiretroviral adherence among former and current substance users may be useful in the creation of successful interventions that target this hard-to-reach population. We performed a cross-sectional study of HIV-infected patients (N = 123) prescribed antiretroviral therapy at four Chicago healthcare venues. Bivariate and multivariable analyses were performed to determine factors associated with non-adherence based on definitions of non-adherence (any missed doses) within the past 4-day, 14-day, and 1-month time periods. Factors consistently associated with non-adherence in bivariate and multivariate analyses, regardless of duration of non-adherence definition, were lower confidence in taking medication consistently and less self-reported ability to read. These data reveal the importance of self-efficacy and ability to read (rather than specific knowledge of CD4 and viral load definitions) in the design of interventions in a population of HIV-infected persons with significant substance use.

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