Influence of chronic illness resources on self-management and the mediating effect of patient activation among patients with coronary heart disease.
Xiaohong Zhang, Hongbo Chen, Yanhui Liu and 1 others
PMID 34498405WHAT IT FOUND
Among patients with coronary heart disease, higher patient activation was linked to better self-management, and activation partly explained the link between illness resources and self-management.
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Key findings
01Higher patient activation was associated with better self-management (r = .585, p < .01).
02Patient activation partly mediated the relationship between chronic illness resources and self-management behaviours, with a mediating effect of 0.230, a direct effect of 0.314, a total effect of 0.544, and a mediating effect of 42.28% of the total effect.
03Medical self-management behaviours had the lowest item mean score (2.71 ± 0.45), while daily life self-management behaviours had the highest (3.50 ± 0.55).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot show cause and effect or true mediation over time. Convenience sampling from two hospitals in Tianjin limits generalisation to other regions or populations. The sample was inpatients and was mostly female, retired, married and living with family, so it may not represent younger, employed, male, divorced or widowed, or community-based patients. Self-report measures can be affected by response bias. The reported patient activation level distribution contains an internal inconsistency. No intervention was tested, so the study cannot show that improving chronic illness resources or patient activation changes self-management.
Declared interests
No conflicts of interest were declared. Funding came from the National Natural Science Foundation of China.
The easy way to misread this
Do not read the partial mediation result as proof that increasing chronic illness resources or patient activation will improve self-management. This was a cross-sectional survey, not an intervention test, and the healthcare team subdomain was not significantly correlated with self-management behaviours.