Pathways to self-management among older adults with multimorbidity in rural China: A fuzzy-set qualitative comparative analysis.
Jianing Yu, Dandan Chen, Yujia Fu and 7 others
PMID 41938002WHAT IT FOUND
In 487 rural older adults with multiple chronic conditions, high self-efficacy sat at the centre of good self-management.
Social support, resilience and resource access shaped different pathways, while low self-efficacy marked poor self-management.
Key findings
01High self-efficacy was a core condition in all configurations linked to high self-management, and low self-efficacy was a core condition in all configurations linked to low self-management.
02No single condition was necessary for high or low self-management; combinations of factors formed six configurations across four contexts.
03Self-efficacy and social support showed the strongest correlations with self-management, and both had the largest standardized regression effects.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a cross-sectional survey, so it shows associations and configurations at one time point, not that any factor caused better self-management. Participants came from rural areas in Zhejiang Province and were recruited through convenience sampling, so results may not apply to other regions or health systems. Self-management was measured by self-report, and some scales were shortened or adapted, which may affect how well they capture older adults' daily management. The analysis did not include some potentially important factors, such as health literacy or family functioning.
Declared interests
Funding came from the Zhejiang Provincial Natural Science Foundation, and the authors declared no conflict of interest.
The easy way to misread this
Do not read these configurations as proof that raising self-efficacy, social support, resilience, or resource access will improve self-management. The study is cross-sectional and observational, so it describes patterns associated with higher or lower self-management, not tested treatment effects.