Self-care agency in systemic lupus erythematosus and its associated factors: a cross-sectional study

Factors influencing self-management behaviors in persons with lupus nephritis: A cross-sectional study

Background

Patients with lupus nephritis experience disease symptoms and side effects from treatment. Although self-management behaviors are important in patients with this disease, there is limited research on the factors influencing these behaviors.

Objective

This study aimed to examine the factors influencing self-management behaviors in patients with lupus nephritis.

Methods

This cross-sectional study was conducted in 240 patients with lupus nephritis at a university hospital in Thailand between August 2019 and December 2020 using a random sampling method. Data were collected using a demographic and clinical characteristic questionnaire, Self-Management Behavior Questionnaire, Self-efficacy for Managing Chronic Disease: A 6-item Scale, Knowledge about Lupus Nephritis Questionnaire, Family Support Scale, Social Networks in Adult Life Questionnaire, and Memorial Symptom Assessment Scale for Lupus Nephritis. Descriptive statistics and multiple linear regression analyses were employed.

Results

The participants reported a moderate level of self-management behaviors. Multiple regression analyses revealed that disease duration, income, symptoms, self-efficacy, knowledge, family support, social networks, and classes of lupus nephritis significantly explained 21% of the variance in self-management behaviors (R2 = 0.21; F(8,231) = 7.73; p <0.001). Family support (β = 0.32, p <0.001) and symptoms (β = -0.23, p <0.001) were significant determinants of self-management behaviors in patients with lupus nephritis.

Conclusion

The findings provide valuable insight for nurses to better understand the factors influencing self-management behaviors in patients with lupus nephritis. Patients with low family support and high symptom severity may face difficulty in performing self-management behaviors. Nurses should pay more attention to these patients and provide family-based interventions to optimize self-management behaviors in this population.

Investigating the role of health information technology in the control and management of Systemic Lupus Erythematosus (SLE): a systematic review

Background

Despite the use of health information technology (HIT) for controlling and managing lupus, its effectiveness has not been well studied. The objective of this study was to investigate the role of HIT in controlling and managing lupus.

Methods

We searched Scopus, PubMed, Web of Science, and Embase, using "self-management", "self-care" and "Systemic Lupus Erythematosus" keywords. Two researchers selected relevant papers and extracted data using a data collection form. Disagreements were resolved in consultation with the third and fourth researchers. After extraction, the data were analyzed.

Results

Totally, 23 papers met the inclusion criteria. About 75% of the studies used web and telephone-based technologies. Most services provided with health technologies were ‘Training’ and ‘consulting’. The ‘lifestyle" and ‘Consultation and education’ axes were the most widely used HIT services to control and manage lupus. While, ‘Better management and control of the disease’, ‘Increasing knowledge and awareness of people about lupus’ and ‘Improving behaviors and attitudes toward self-management and self-care’ were also the most important outcomes. ‘Collectiing patient data and information’, 'Providing education and consultation services to patients', 'Measuring patient-reported outcomes', and 'Increasing patients' knowledge and awareness of their disease' were the most important advantages of various technologies. 'Slow internet speed' and 'Challenges and problems related to appearance and usability' and 'Patient concerns about privacy and misuse of their data' were three disadvantages of technologies.

Conclusion

The findings showed that HIT can improve the management and control of lupus and facilitate self-efficacy, self-care, and self-management in patients. The axes and data elements identified in this study can be the basis for developing and implementing efficient HIT-based systems to improve, control, and manage lupus.

The Appraisal of Self-Care Agency Scale-Revised (ASAS-R): Reliability and Validity among Portuguese Medical Students

Self-care agency plays an important role in an individual's health. Considering the particularities of their education, it can be a protective factor for the mental health of medical students. This study aims to validate the Portuguese version of the Appraisal of Self-care Agency Scale-Revised (ASAS-R) in Portuguese medical students. A cross-sectional, quantitative, and analytical online study was conducted between 23 April 2021, and 15 July 2021. Exploratory factor analysis (EFA) was performed to test the internal structure of the ASAS-R. Correlations with the SHS (Subjective Happiness Scale), SWLS (Satisfaction with Life Scale), and MHI (Mental Health Inventory) were calculated using Pearson's coefficient so as to test convergent validity. Internal consistency was evaluated using inter-item correlation, corrected item-total correlation, and Cronbach's alpha. The total sample included 781 individuals. EFA yielded a 3-factor solution accounting for 53.9% of the explained variance. Pearson's coefficients obtained between the 3 factors of ASAS-R and the total scores of the 3 construct-related scales demonstrated adequate convergent validity. Total Cronbach's alpha value was 0.85, while the Cronbach's alpha of the three factors was 0.81, 0.55, and 0.83, respectively. This study demonstrated that ASAS-R is a valid and reliable instrument for measuring self-care agency among Portuguese medical students.