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Self-management across chronic diseases: Targeting education and support needs
Institution:1. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada;2. St Mary’s Research Centre, Montreal, Quebec, Canada;3. Department of Psychiatry, McGill University, Montreal, Quebec, Canada;4. Department of Family Medicine, McGill University, Montreal, Quebec, Canada;5. Family Medicine Centre, St. Mary’s Hospital Center, Montreal, Quebec, Canada;6. Department of Economics, McGill University, Montreal, Quebec, Canada;7. Department of Medicine, McGill University, McGill University Health Centre, Montreal, Quebec, Canada;8. Divisions of Gastroenterology and Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada;9. School of Social Work, McGill University, Montreal, Quebec, Canada;10. Department of Psychology, Montreal Behavioural Medicine Centre, Montreal, Quebec, Canada;11. Research Center, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
Abstract:ObjectivesAmong Canadian adults with chronic disease: 1) to identify groups that differ in self-management task frequency and self-efficacy; 2) to compare group characteristics and preferences for self-management support.MethodsUsing data from an online survey, cluster analysis was used to identify groups that differed in self-management task frequency and self-efficacy. Multivariable regression was used to explore relationships with patient characteristics and preferences.ResultsCluster analysis (n = 247) revealed three groups:Vulnerable Self-Managers (n = 55), with the highest task frequency and lowest self-efficacy; Confident Self-Managers (n = 73), with the lowest task frequency and highest self-efficacy; and Moderate Needs Self-Managers (n = 119), with intermediate task frequency and self-efficacy. Vulnerable Self-Managers, when compared with the Confident group, were more often: on illness-related employment disability or unemployed; less well educated; diagnosed with emotional problems or hypertension, and had greater multimorbidity. They participated less often in self-management programs, and differed in support preferences.ConclusionsKnowing the characteristics of vulnerable self-managers can help in targeting those in greater need for self-management support that matches their preferences.Practice ImplicationsDifferent approaches are needed to support self-management in the vulnerable population.
Keywords:Chronic disease  Education  Multimorbidity  Self-management  Self-efficacy
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