Rheumatology Advance Access originally published online on April 9, 2008
Rheumatology 2008 47(6):881-886; doi:10.1093/rheumatology/ken126
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© Published by Oxford University Press on behalf of the British Society for Rheumatology 2008.
Patient perceptions about illness self-management in ANCA-associated small vessel vasculitis
1Department of Population Health Sciences, University of Wisconsin, Madison, 2Department of Health Behavior and Health Education, University of North Carolina, 3Thurston Arthritis Research Center, University of North Carolina, 4Department of Pharmaceutical Outcomes and Policy, University of North Carolina, 5UNC Kidney Center and Division of Nephrology and Hypertension, University of North Carolina and 6RTI International, Durham, NC, USA.
Correspondence to: T. Thorpe, Health Innovation Program, Department of Population Health Sciences, University of Wisconsin, E5/724 CSC, 600 Highland Avenue, Madison, WI 53792-7685, USA. E-mail: thorpecarolyn{at}gmail.com
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Abstract |
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Objectives. To characterize patient perceptions, related to eight self-management behaviours relevant for adults with ANCA-associated small vessel vasculitis (ANCA-SVV), and to determine if these perceptions were associated with performance of each behaviour.
Methods. Adults with ANCA-SVV (n = 202) completed a self-administered questionnaire that assessed eight self-management behaviours (adherence to recommendations for medication, health service use, diet, exercise, infection avoidance and symptom monitoring; prompt reporting of symptoms and side effects; and adjusting activities in response to symptoms), perceptions about these behaviours, socio-demographics, clinical factors and social desirability bias. Descriptive statistics were generated to characterize patients’ perceptions about difficulty of, importance of, and specific barriers to performing each behaviour. Regression analyses explored whether these variables were associated with performing each behaviour, controlling for potential confounders.
Results. With few exceptions, higher perceived importance and lower perceived difficulty of each behaviour were associated with more frequent performance of the behaviour. For each behaviour, several specific barriers were frequently endorsed by patients and a number of these were associated with lower levels of self-management.
Conclusion. This study reveals that patient perceptions about the illness and its treatment influence ANCA-SVV self-management. Perceived barriers to medication, health services, diet and exercise adherence were similar to those in other illnesses. This study also provides insight into barriers experienced by patients in performing behaviours (infection avoidance, symptom monitoring, reporting symptoms and side-effects and adjusting activities) not often previously studied. How the identification of these barriers can help inform future interventions for ANCA-SVV patients is to be discussed.
KEY WORDS: Antineutrophil cytoplasmic antibodies-associated vasculitis, Self-management, Adherence, Health behaviour, Barriers
Submitted 11 September 2007;
revised version accepted 25 February 2008.
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