HEALTH MANAGEMENT IN PATIENTS WITH CHRONIC DISEASES: FACTORS IMPROVING SELF-CARE MASTERING

Abstract

"Background: Chronic Diseases (CD) such as diabetes, musculoskeletal disorders, cardiovascular diseases, neurological disorders, and cancers increase with age and place a burden on individuals and healthcare systems, and more they are associated with a lower Quality of Life (QoL) in the elderly. CD conditions suggested improvements of self-care investigations switching research perspectives from medication or dietary adherence, biological exams, or symptoms management to maintaining health through treatment adherence and health-promoting practices. Objective: Aim of the present study was to evaluate the health management of chronic disease, analyzing the effectiveness of self-care and the emotional dimensions (anxiety, stress, depression). Materials and Methods: We conducted an observational study on 132 outpatient patients aged 18 to 75 years (mean age 52.6 years, SD ± 12.4) diagnosed with CD; 57,5% of the sample were females. The participants were enrolled at the Clinical Medicine Division of S. Salvatore Hospital in L’Aquila, ASL1 Abruzzo (IT). The psychological battery was composed of three standardized self-assessment measured emotional traits (DASS-21), QoL (WHOQOL-26), and Self-Care (SC-CII). Participants were divided into 2 groups based on CD as follows: a) cardiovascular disease (ex. cardiological disease) (CVD) group was composed of 68 patients (51.5%), b) other disease group (ex. disorders of the locomotor, gastrointestinal, and urogenital systems) (OD) was composed of 64 patients (48.5%). Results: Descriptive analyses based on sociodemographic and clinical characteristics showed no difference among all the variables (gender, education, marital status, occupation, and timing diagnosis). One-way ANOVA was performed comparing the emotional dimensions for both CVD/OD groups. Statistical analysis showed significant difference in the OD group which showed greater signs of anxiety (p=0.029), depression (p=0.007), and stress (p=0.013), than the CVD group. Then, we performed Pearson’s correlation to compare the QoL with the ability to self-care index. The results highlighted a significant correlation between self-care maintenance, self-efficacy, and QoL. Discussion and Conclusion: Our results show that, among CDs, patients with gastrointestinal, locomotor, and urogenital diseases appear to suffer more than patients with cardiovascular disease. The QoL is compromised in the maintenance of physical and mental health, in social relationships and, in self-efficacy index; the study highlights those actions could be planned for a person-centered approach with the aim of planning a better health outcome in CDs to progressively involve patients in overall self-care."