Email Alert | RSS

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

Previous Articles     Next Articles

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)

RICH HTML

   

PDF (PC)

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
1 沈南, 赵毅, 段利华, 等. 系统性红斑狼疮诊疗规范[J]. 中华内科杂志, 2023, 62 (7): 775- 784.
2 中华医学会风湿病学分会, 国家皮肤与免疫疾病临床医学研究中心, 中国系统性红斑狼疮研究协作组. 2020中国系统性红斑狼疮诊疗指南[J]. 中华内科杂志, 2020, 59 (3): 172- 185.
3 Allegrante JP , Wells MT , Peterson JC . Interventions to support behavioral self-management of chronic diseases[J]. Annu Rev of Public Health, 2019, 40, 127- 146.
doi: 10.1146/annurev-publhealth-040218-044008
4 朱茜茜, 杨惠云. 聚焦解决模式在慢性病自我管理中的应用研究进展[J]. 护理学杂志, 2024, 39 (3): 126- 128.
5 颜艳, 王彤. 医学统计学[M].5版北京:人民卫生出版社, 2020: 580- 587.
6 Polit DF , Beck CT , Owen SV . Is the CVI an acceptable indicator of content validity? Appraisal and recommendations[J]. Res Nurs Health, 2007, 30 (4): 459- 467.
doi: 10.1002/nur.20199
7 刘璐, 张娟, 张晓瑜, 等. 鼻饲患者误吸风险评估量表的编制及信效度检验[J]. 中华护理杂志, 2022, 57 (3): 337- 342.
8 张文惠. 食管癌患者术后自我感受负担与家庭关怀度的相关性[J]. 河南医学研究, 2023, 32 (3): 483- 486.
9 谢宇飞, 陈川, 左嘉豪, 等. 家庭关怀度指数问卷在毒品滥用者中的信效度检验[J]. 南昌大学学报(医学版), 2023, 63 (5): 66- 70.
10 丁向军. 哮喘患者自我效能感与家庭功能的关系[J]. 河南医学研究, 2023, 32 (1): 102- 105.
11 徐慧, 刘梨花, 赵志娜, 等. 系统性红斑狼疮患者自我管理水平及影响因素[J]. 中华健康管理学杂志, 2023, 17 (7): 520- 524.
12 Drenkard C , Dunlop-Thomas C , Easley K , et al. Benefits of a self-management program in low-income African-American women with systemic lupus erythematosus: Results of a pilot test[J]. Lupus, 2012, 21 (14): 1586- 1593.
doi: 10.1177/0961203312458842
13 Fortin PR , Costa DA , Neville C , et al. Challenges of perceived self-management in lupus[J]. Arthritis Care Res (Hoboken), 2022, 74 (7): 1113- 1121.
doi: 10.1002/acr.24542
14 王梓彤, 马松翠, 徐丽丽, 等. 肢体残疾人自我效能感、照顾质量与生活质量的关系[J]. 中国康复理论与实践, 2023, 29 (3): 340- 348.
15 王志霞, 陈妍伶, 陈红. 系统性红斑狼疮患者正负性情绪影响因素的路径分析研究[J]. 中国实用护理杂志, 2023, 39 (28): 2191- 2198.
16 周慧玲, 吴庆, 李云云, 等. 老年脑卒中患者生存质量与医学应对方式和自我效能的相关性研究[J]. 国际老年医学杂志, 2023, 44 (6): 650- 655.
17 张改萍, 田晓英. 接受抗病毒治疗的慢性乙型肝炎病人自我管理能力现状及影响因素[J]. 护理研究, 2023, 37 (12): 2258- 2261.
18 Taylor SE , Stanton AL . Coping resources, coping processes, and mental health[J]. Annu Rev Clin Psychol, 2007, 3, 377- 401.
doi: 10.1146/annurev.clinpsy.3.022806.091520
19 祁梦君, 门雪妍, 龚丽. 女性系统性红斑狼疮患者家庭功能及其影响因素分析[J]. 风湿病与关节炎, 2020, 9 (8): 29- 32.
20 陈梦越, 李晶, 刘春娜, 等. 女性狼疮患者生活质量与家庭婚姻功能的相关性研究[J]. 护理学杂志, 2018, 33 (19): 32- 34.
21 蒋新军, 张彩虹, 李明子. 糖尿病患者自我管理教育参与的影响因素及其干预措施的研究进展[J]. 中华糖尿病杂志, 2021, 13 (3): 287- 290.
22 李谦华, 戴冽. 2016年英国风湿病学会和英国风湿病卫生专业人员协会妊娠期和哺乳期处方用药指南解读: 第一部分经典抗风湿药生物制剂和糖皮质激素[J]. 中国实用妇科与产科杂志, 2016, 32 (10): 924- 928.
[1] Hongyan WANG, Xinming LI, Kechi FANG, Huaqun ZHU, Rulin JIA, Jing WANG. Analysis of characteristics related to the disease activity of systemic lupus erythematosus and construction of an evaluation model [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 1017-1022.
[2] Dandan CHEN, Yun LI, Qingyi LU, Xiaohong XIANG, Feng SUN, Yingni LI, Jing ZHAO, Hongyan WANG, Chun LI. Ovarian function in patients of childbearing age with systemic lupus erythematosus [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 1023-1028.
[3] Jing CHAI, Yue WANG, Rong MU, Jinxia ZHAO. Systemic lupus erythematosus involving the fornix column leading to hyponatremia: A case report [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 1115-1118.
[4] Mingxia WANG, Ling DING, Min WANG, Chanjuan ZOU, Siyu YAN, Yingwen LIANG, Weijia WANG, Shanzhi HE. Safe pregnancy and delivery in a female patient with systemic lupus erythematosus after discontinuation of dual-target chimeric antigen receptor T cells therapy [J]. Journal of Peking University (Health Sciences), 2024, 56(6): 1119-1125.
[5] Zhihui WU, Mingzhi HU, Qiaoying ZHAO, Fengfeng LV, Jingying ZHANG, Wei ZHANG, Yongfu WANG, Xiaolin SUN, Hui WANG. Immunomodulatory mechanism of umbilical cord mesenchymal stem cells modified by miR-125b-5p in systemic lupus erythematosus [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 860-867.
[6] Limin REN,Chuchu ZHAO,Yi ZHAO,Huiqiong ZHOU,Liyun ZHANG,Youlian WANG,Lingxun SHEN,Wenqiang FAN,Yang LI,Xiaomei LI,Jibo WANG,Yongjing CHENG,Jiajing PENG,Xiaozhen ZHAO,Miao SHAO,Ru Li. Low disease activity and remission status of systemic lupus erythematosus in a real-world study [J]. Journal of Peking University (Health Sciences), 2024, 56(2): 273-278.
[7] Zhi-jun LUO,Jia-jia WU,You SONG,Chun-li MEI,Rong DU. Systemic lupus erythematosus associated macrophage activation syndrome with neuropsychiatric symptoms: A report of 2 cases [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 1111-1117.
[8] Hai-hong YAO,Fan YANG,Su-mei TANG,Xia ZHANG,Jing HE,Yuan JIA. Clinical characteristics and diagnostic indicators of macrophage activation syndrome in patients with systemic lupus erythematosus and adult-onset Still's disease [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 966-974.
[9] Xiang-ge ZHAO,Jia-qing LIU,Hui-na HUANG,Zhi-min LU,Zi-ran BAI,Xia LI,Jing-jing QI. Interferon-α mediating the functional damage of CD56dimCD57+natural killer cells in peripheral blood of systemic lupus erythematosuss [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 975-981.
[10] Xiao-yue ZHANG,Yu-xin LIN,Ying JIANG,Lan-chao ZHANG,Mang-yan DONG,Hai-yi CHI,Hao-yu DONG,Li-jun MA,Zhi-jing LI,Chun CHANG. Mediating effect of self-efficacy on self-management ability and self-management behavior in patients with type 2 diabetes mellitus [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 450-455.
[11] Miao SHAO,Hui-fang GUO,Ling-yan LEI,Qing ZHAO,Yan-jie DING,Jin LIN,Rui WU,Feng YU,Yu-cui LI,Hua-li MIAO,Li-yun ZHANG,Yan DU,Rui-ying JIAO,Li-xia PANG,Li LONG,Zhan-guo LI,Ru LI. A multicenter study on the tolerance of intravenous low-dose cyclophosphamide in systemic lupus erythematosus [J]. Journal of Peking University (Health Sciences), 2022, 54(6): 1112-1116.
[12] Min LI,Lin-qing HOU,Yue-bo JIN,Jing HE. Clinical and immunological characteristics of systemic lupus erythematosus with retinopathy [J]. Journal of Peking University (Health Sciences), 2022, 54(6): 1106-1111.
[13] Lin-qi ZHANG,Jing ZHAO,Hong-yan WANG,Zong-yi WANG,Ying-ni LI,Ji-yang TANG,Si-ying LI,Jin-feng QU,Ming-wei ZHAO. Relationship between anti-ENO1 antibody and systemic lupus erythematosus patients with retinopathy [J]. Journal of Peking University (Health Sciences), 2022, 54(6): 1099-1105.
[14] Jian-mei ZOU,Li-jun WU,Cai-nan LUO,Ya-mei SHI,Xue WU. Relationship of serum 25- hydroxy vitamin D and systemic lupus erythematosus [J]. Journal of Peking University (Health Sciences), 2021, 53(5): 938-941.
[15] XIA Fang-fang,LU Fu-ai,LV Hui-min,YANG Guo-an,LIU Yuan. Clinical characteristics and related factors of systemic lupus erythematosus with interstitial pneumonia [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 266-272.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd