Abstract
Background: Self-management is a key element in person-centered and integrated care. It involves several related concepts, such as self-management ability, behavior, and support. These concepts are poorly delineated. The aim of this study was to examine hypothesized associations between self-management ability, behavior, and support in older adults (taking their frailty and complexity of care needs into account) and to examine underlying aspects of these concepts, if these hypotheses lacksupport.Methods: Cross-sectional data from the Embrace study, a stratified randomized controlled trial, evaluating person-centered and integrated care in Dutch community-living older adults, were used. Participants (n=537) were aged 75 and older, assigned to health-related risk profiles based on self-reported frailty and complexity of care needs. Ability was assessed with the Self-Management Ability Scale, behavior with the Partner in Health Scale for Older Adults, and support with the Patient Assessment of Integrated Elderly Care.Results: Ability and behavior were positively associated for participants with the risk profiles “Robust” and “Complex care needs” (betas are 0.38 and 0.46). Coping (an aspect of behavior) turned out to be a key element for participants with risk profiles “Robust” and “Complex care needs” (betas ranging from 0.13 to 0.45). Support was associated with aspects of behavior, varying per risk profile.Conclusion: We found no associations for self-management on the conceptual level, but the aspect coping did appear to play a major role. Improving coping strategies of older adults may be a promising way of enhancing self-management ability, and of reducing the need for self-management support.
The impact of COVID-19 on chronic care according to providers: a qualitative study among primary care practices in Belgium