TY - JOUR
T1 - Symptom characteristics, perceived causal attributions, and contextual factors influencing self-care behaviors
T2 - An ecological daily assessment study of adults with chronic illness
AU - Riegel, Barbara
AU - Page, Shayleigh Dickson
AU - Aryal, Subhash
AU - Lee, Christopher S.
AU - Belfiglio, Andrew
AU - Freedland, Kenneth E.
AU - Stromberg, Anna
AU - Vellone, Ercole
AU - Westland, Heleen
AU - van Rijn, Michelle M.
AU - Pettersson, Sara
AU - Wiebe, Douglas J.
AU - Jaarsma, Tiny
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/6
Y1 - 2024/6
N2 - Objective: Insights into how symptoms influence self-care can guide patient education and improve symptom control. This study examined symptom characteristics, causal attributions, and contextual factors influencing self-care of adults with arthritis, asthma, chronic obstructive pulmonary disease, diabetes, or heart failure. Methods: Adults (n = 81) with a symptomatic chronic illness participated in a longitudinal observational study. Using Ecological Daily Assessment, participants described one symptom twice daily for two weeks, rating its frequency, severity, bothersomeness, duration, causes, and self-care. Results: The most frequent symptoms were fatigue and shortness of breath. Pain, fatigue, and joint stiffness were the most severe and bothersome. Most participants engaged in active self-care, but those with fatigue and pain engaged in passive self-care (i.e., rest or do nothing), especially when symptoms were infrequent, mild, somewhat bothersome, and fleeting. In people using passive self-care, thoughts, feelings, and the desire to conceal symptoms from others interfered with self-care. Conclusion: Most adults with a chronic illness take an active role in managing their symptoms but some conceal or ignore symptoms until the frequency, severity, bothersomeness, or duration increases. Practice implications: When patients report symptoms, asking about self-care behaviors may reveal inaction or ineffective approaches. A discussion of active self-care options may improve symptom control.
AB - Objective: Insights into how symptoms influence self-care can guide patient education and improve symptom control. This study examined symptom characteristics, causal attributions, and contextual factors influencing self-care of adults with arthritis, asthma, chronic obstructive pulmonary disease, diabetes, or heart failure. Methods: Adults (n = 81) with a symptomatic chronic illness participated in a longitudinal observational study. Using Ecological Daily Assessment, participants described one symptom twice daily for two weeks, rating its frequency, severity, bothersomeness, duration, causes, and self-care. Results: The most frequent symptoms were fatigue and shortness of breath. Pain, fatigue, and joint stiffness were the most severe and bothersome. Most participants engaged in active self-care, but those with fatigue and pain engaged in passive self-care (i.e., rest or do nothing), especially when symptoms were infrequent, mild, somewhat bothersome, and fleeting. In people using passive self-care, thoughts, feelings, and the desire to conceal symptoms from others interfered with self-care. Conclusion: Most adults with a chronic illness take an active role in managing their symptoms but some conceal or ignore symptoms until the frequency, severity, bothersomeness, or duration increases. Practice implications: When patients report symptoms, asking about self-care behaviors may reveal inaction or ineffective approaches. A discussion of active self-care options may improve symptom control.
KW - Chronic illness
KW - Ecological daily assessment
KW - Self-care
KW - Self-management
KW - Signs and symptoms
UR - http://www.scopus.com/inward/record.url?scp=85186519424&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2024.108227
DO - 10.1016/j.pec.2024.108227
M3 - Article
C2 - 38430731
AN - SCOPUS:85186519424
SN - 0738-3991
VL - 123
JO - Patient Education and Counseling
JF - Patient Education and Counseling
M1 - 108227
ER -