Routine healthcare disruptions: a longitudinal study on changes in self-management behavior during the COVID-19 pandemic.
Routine healthcare disruptions: a longitudinal study on changes in self-management behavior during the COVID-19 pandemic.
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常规医疗保健干扰：一项关于19009年大流行期间自我管理行为变化的纵向研究。
DOI：
10.1186/s12913-023-09119-x
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发表时间：
2023-02-24
影响因子：
2.8
通讯作者：
Boeije, Hennie
中科院分区：
文献类型：
--
作者：
Menting, Juliane;van Schelven, Femke;Aussems, Claire;Heijmans, Monique;Boeije, Hennie
2019冠状病毒病疫情对专业护理的常规工作和连续性产生了重大影响。作为这种专业护理的频繁使用者，特别是患有慢性疾病的人，这产生了后果。由于在获得医疗保健方面存在障碍，因此对这一群体的自我管理行为提出了更大的呼吁。在本研究中，我们的目标是调查自我管理在最近的大流行期间发生了多大程度的变化，以及哪些因素促成了这些变化。荷兰“慢性病或残疾人国家小组”被用来收集至少患有一种慢性病的人的自我报告数据。在两个时间点，即2018年危机前和2020年秋季第二波危机期间，使用健康合作伙伴问卷对自我管理进行了评估。配对t检验用于分析自我管理的变化。2020年对患者、组织和环境三个层面的潜在相关因素进行了评估，并使用多项逻辑回归测试了它们对自我管理变化的影响。345名小组成员在两个时间点提供了数据。大多数人的自我管理行为是稳定的（70.7%）。大约七分之一的人自我管理得到改善（15.1%），相似比例的人自我管理恶化（14.2%）。性别、身体残疾、心理健康和因COVID-19引起的日常压力源（患者层面）、医疗保健可及性的变化（组织层面）和社会支持（环境层面）与自我管理经历的变化显著相关。慢性疾病患者在COVID-19期间经历了不同的自我管理变化轨迹。我们需要注意那些似乎更容易受到医疗危机影响、自我管理能力不太稳定的人，比如那些有精神健康问题或日常压力的人。护理和社会支持的连续性可以缓冲保健危机对慢性病患者自我管理日常活动的影响。
The outbreak of COVID-19 had a significant impact on routines and continuity of professional care. As frequent users of this professional care, especially for people with chronic diseases this had consequences. Due to barriers in access to healthcare, an even greater appeal was made on the self-management behaviors of this group. In the present study, we aim to investigate the extent to which self-management changed during the recent pandemic, and which factors contributed to these changes. The Dutch ‘National Panel of people with Chronic Illness or Disability’ was used to collect self-reported data of people with at least one chronic disease. Self-management was assessed with the Partners in Health questionnaire at two time points: before the crisis in 2018 and during the second wave of crisis in Autumn 2020. Paired t-tests were used to analyze changes in self-management. Potential associating factors on three levels – patient, organization and environment – were assessed in 2020 and their impact on self-management changes was tested with multinomial logistic regression. Data from 345 panel members was available at two time points. In the majority of people, self-management behaviors were stable (70.7%). About one in seven experienced improved self-management (15.1%), and a similar proportion experienced deteriorated self-management (14.2%). Sex, physical disability, mental health and daily stressors due to COVID-19 (patient level), changes in healthcare access (organization level), and social support (environment level) were significantly associated with experienced changes in self-management. People with chronic diseases experienced different trajectories of self-management changes during COVID-19. We need to be aware of people who seem to be more vulnerable to a healthcare crisis and report less stable self-management, such as those who experience mental health problems or daily stressors. Continuity of care and social support can buffer the impact of a healthcare crisis on self-management routines of people with chronic diseases.
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影响因子：
2.9
作者：
Lovett RM;Opsasnick L;Russell A;Yoon E;Weiner-Light S;Serper M;Cooper Bailey S;Wolf MS
通讯作者：
Wolf MS
影响因子：
3.5
作者：
Kendzerska T;Zhu DT;Gershon AS;Edwards JD;Peixoto C;Robillard R;Kendall CE
通讯作者：
Kendall CE
影响因子：
12.7
作者：
Grady, Patricia A.;Gough, Lisa Lucio
通讯作者：
Gough, Lisa Lucio
影响因子：
3.5
作者：
Jerant, AF;von Friederichs-Fitzwater, MM;Moore, M
通讯作者：
Moore, M
影响因子：
2.9
作者：
Astill Wright L;Gnanapragasam S;Downes AJ;Bisson JI
通讯作者：
Bisson JI