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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (6): 1029-1035. doi: 10.19723/j.issn.1671-167X.2024.06.013

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Current status and influential factors of self-management ability in patients with systemic lupus erythematosus

Li WANG, Chao GAO*(), Huanhuan REN, Yanping SHEN, Xiaowei HUANG, Hong YAO, Dandan HAN   

  1. Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
  • Received:2024-06-02 Online:2024-12-18 Published:2024-12-18
  • Contact: Chao GAO E-mail:13581575523@163.com
  • Supported by:
    Peking University People' s Hospital Scientific Research Development Funds(RDN2022-17)

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Abstract:

Objective: To investigate the current status of self-management ability in patients with systemic lupus erythematosus (SLE), and to analyze the related factors affecting the self-management ability of SLE patients. Methods: A total of 180 SLE patients who were selected from the outpatient department and ward of the Department of Rheumatology and Immunology of a Tertiary Hospital in Beijing from January 2024 to March 2024. General information questionnaire, SLE self-management ability assessment scale, general self-efficacy scale (GSES) and family concern index questionnaire (APGAR) were used for questionnaire investigation, so as to investigate the current status and related influencing factors of self-management ability in patients with SLE. Results: A total of 170 questionnaires were effectively collected, and the total score of self-management ability was (90.94±14.26) points, of which 103 patients were 89-110 points, accounting for 60.6%; 60 patients were 67-88 points, accounting for 35.3%; 7 patients were 0-66 points, accounting for 4.1%; The results of univariate analysis showed that personal monthly income, follow-up frequency, family caring index, self-efficacy and SLE self-management ability score had statistical significance (P < 0.05). Spearman rank correlation analysis showed that family caring index, self-efficacy scores were positively correlated with the scores of various dimensions and the total score of SLE self-management scores (P < 0.001). Multivariate Logistic regression analysis showed that family caring index (OR=1.503, 95%CI=1.186-1.906), self-efficacy (OR=1.103, 95%CI=1.038-1.172), personal monthly income of 5 000-8 000 yuan/month (OR=0.120, 95%CI=0.022-0.645) and 1-2 weeks return frequency (OR=0.044, 95%CI=0.003-0.575) were significant influencing factors for SLE patients' self-management ability. Conclusion: The results of this study indicate that patients with SLE have a good level of self-management ability. In the process of chronic disease management, medical staff should formulate detailed and layered intervention measures to further improve self-management ability with SLE patients, and at the same time, help SLE patients establish good family caring index and patient self-efficacy, which is conducive to improving self-management ability of SLE patients, so as to effectively promote disease management and improve the quality of life.

Key words: Systemic lupus erythematosus, Self-management, Self-efficacy, Family concern index

CLC Number: 

  • R593.2

Table 1

Distribution of dimensions and total scores of systemic lupus erythematosus self-management ability(n=170)"

Score Cases, n (%) Total, ${\bar x}$±s Disease cognitive management, ${\bar x}$ ±s Daily life management, ${\bar x}$±s Emotional & social management, ${\bar x}$±s Disease monitoring & fertility management, ${\bar x}$±s
0-66 7 (4.1) 50.14±16.31 16.43±7.79 12.57±5.88 13.43±5.53 7.71±3.15
67-88 60 (35.3) 80.72±5.92 28.02±3.25 21.78±3.80 19.67±2.71 11.25±3.92
89-110 103 (60.6) 99.66±6.95 33.11±2.39 26.71±2.30 23.53±1.69 16.31±3.44

Table 2

Univariate analysis of general demographic data and systemic lupus erythematosus self-management level(n=170)"

Items Cases，n (%) Self-management level/score，M (P25, P75) F/t P value
Gender 0.246 0.621
    Male 16 (9.4) 88.0 (79.8，97.3)
    Female 154 (90.6) 92.5 (83.0，100.3)
Age/years 0.767 0.514
    ≤22 17 (10.0) 91.0 (85.0，100.0)
    >22-45 116 (68.2) 92.0 (86.0，103.0)
    >45-59 26 (15.3) 89.0 (81.0，98.0)
    >59 11 (6.5) 96.0 (77.0，106.0)
Degree of education 0.677 0.609
    Primary and junior high school 24 (14.1) 88.5 (78.5，104.0)
    High /vocational school 33 (19.4) 92.0 (85.0，97.5)
    Junior college 39 (22.9) 93.0 (84.0，102.0)
    Undergraduate 57 (33.5) 92.0 (81.5，100.0)
    Graduate students and above 17 (10.0) 99.0 (89.5，105.0)
Marital status 0.222 0.801
    Married 106 (62.4) 92.0 (83.8，103.0)
    Unmarried 57 (33.5) 91.0 (82.0，100.0)
    Divorce/widowed 7 (4.1) 96.0 (81.0，107.0)
Career 1.355 0.236
    No 50 (29.4) 88.0 (78.8，97.3)
    Management 15 (8.8) 96.0 (84.0，99.0)
    Service 42 (24.7) 93.0 (85.8，105.5)
    Education 16 (9.4) 95.0 (73.5，106.0)
    Medical 7 (4.1) 99.0 (92.0，110.0)
    Technology 5 (2.9) 93.0 (84.0，106.5)
    Other 35 (20.6) 92.0 (86.0，102.0)
Monthly income/yuan 3.155 0.016
    ≤1 000 37 (21.8) 89.0 (78.5，98.0)
    >1 000-3 000 24 (14.1) 88.0 (78.5，99.3)
    >3 000-5 000 50 (29.4) 92.0 (85.5，98.3)
    >5 000-8 000 21 (12.4) 92.0 (78.5，101.0)
    >8 000 38 (22.4) 98.5 (91.0，106.5)
Medical expenses 2.927 0.056
    Self-paied 18 (10.6) 87.0 (76.5，93.5)
    Publicly funded 15 (8.8) 85.0 (81.0，97.0)
    Medical insurance 137 (80.6) 93.0 (86.0，103.0)
Disease course/years 1.074 0.371
    ≤5 74 (43.5) 94.0 (87.0，103.3)
    > 5-10 35 (20.6) 93.0 (81.0，98.0)
    >10-15 30 (17.6) 92.0 (79.8，98.0)
    >15-20 20 (11.8) 88.0 (82.8，103.8)
    >20 11 (6.5) 91.0 (83.0，100.0)
Number of complications 1.084 0.366
    0 35 (20.6) 96.0 (88.0，105.0)
    1 87 (51.2) 92.0 (83.0，103.0)
    2 28 (16.5) 89.0 (79.8，97.0)
    3 12 (7.1) 90.0 (80.3，100.0)
    4 8 (4.7) 85.5 (74.8，94.2)
Medication categories 0.201 0.896
    1-2 25 (14.7) 91.0 (84.5，99.5)
    3-5 87 (51.2) 92.0 (81.0，100.0)
    6-8 35 (20.6) 96.0 (86.0，100.0)
    ≥9 23 (13.5) 95.0 (84.0，104.0)
Frequency of follow-up 3.689 0.013
    1-2 weeks 8 (4.7) 87.0 (57.5，91.8)
    3-4 weeks 73 (42.9) 95.0 (87.0，105.0)
    2-5 months 45 (26.5) 92.0 (82.0，99.5)
    6-12 months 44 (25.9) 90.0 (80.3，110.0)
Family functioning level 11.015 < 0.001
    Severely impaired 8 (4.7) 78.0 (69.0，81.5)
    Moderately impaired 18 (10.6) 83.0 (74.5，94.0)
    Fine 144 (84.7) 93.0 (87.0，103.0)
Self-efficacy score 20.234 < 0.001
    0-10 0
    11-20 22 (12.9) 82.5 (71.5，87.5)
    21-30 78 (45.9) 91.0 (81.3，97.0)
    31-40 70 (41.2) 99.0 (89.0，108.0)

Table 3

Family care assessment index and self-efficacy score were correlated with Spearman rank of all dimensions and total score of systemic lupus erythematosus self-management"

Self-management ability Family care assessment P value General self-efficacy P value
Disease cognition management 0.347 < 0.001 0.462 < 0.001
Daily life management 0.351 < 0.001 0.348 < 0.001
Emotional & Social management 0.299 < 0.001 0.392 < 0.001
Disease monitoring & Fertility management 0.257 < 0.001 0.458 < 0.001
Total 0.388 < 0.001 0.457 < 0.001

Table 4

Analysis of related factors of self-management ability in patients with systemic lupus erythematosus"

Variable Univariate analysis Multivariate analysis
OR (95%CI) P OR (95%CI) P
Family concern index 1.410 (1.184-1.680) < 0.001 1.503 (1.186-1.906) < 0.001
Self-efficacy 1.128 (1.074-1.184) < 0.001 1.103 (1.038-1.172) 0.002
Monthly income/yuan 0.026 0.146
    ≤1 000 0.212 (0.078-0.572) 0.002 0.404 (0.070-2.324) 0.310
    >1 000-3 000 0.222 (0.074-0.668) 0.007 0.244 (0.039-1.516) 0.130
    >3 000-5 000 0.364 (0.143-0.925) 0.034 0.273 (0.066-1.124) 0.072
    >5 000-8000 0.341 (0.110-1.064) 0.064 0.120 (0.022-0.645) 0.014
Frequency of follow-up 0.111 0.027
    1-2 weeks 0.400 (0.073-2.204) 0.293 0.044 (0.003-0.575) 0.017
    3-4 weeks 2.044 (0.956-4.373) 0.065 1.869 (0.625-5.588) 0.263
    2-5 months 1.371 (0.596-3.157) 0.458 1.756 (0.539-5.718) 0.350
Degree of education 0.207 0.714
    Primary and junior high school 0.185 (0.046-0.743) 0.017 0.276 (0.029-2.611) 0.261
    High /vocational school 0.327 (0.088-1.214) 0.095 0.515 (0.061-4.322) 0.541
    Junior college 0.359 (0.099-1.298) 0.118 0.669 (0.083-5.366) 0.705
    Undergraduate 0.349 (0.114-1.357) 0.140 0.478 (0.710-3.240) 0.450
Career 0.100 0.065
    No 0.332 (0.136-0.815) 0.016 0.383 (0.107-1.374) 0.141
    Management 0.675 (0.199-2.297) 0.530 0.284 (0.054-1.479) 0.135
    Service 0.869 (0.346-2.184) 0.765 1.317 (0.398-4.364) 0.652
    Education 0.985 (0.290-3.344) 0.980 2.879 (0.434-19.085) 0.273
    Medical 3.545 (0.383-32.817) 0.265 8.649 (0.717-104.369) 0.273
    Technology 0.886 (0.130-6.022) 0.902 8.377 (0.223-314.259) 0.250
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