Self-management support needs of patients with chronic illness: do needs for support differ according to the course of illness?

Objective: To determine whether chronically ill patients’ needs for self-management support depend on their course of illness. Methods: Cross-sectional and longitudinal linear regression analyses were conducted using data from 1300 patients with chronic disease(s) who participated in a nationwide Dutch panel-study. Selfmanagement support needs were assessed by the Patient Assessment of Self-management Tasks questionnaire (PAST). Course of illness was operationalized as: illness duration, patients’ perception of the course of illness and changes in self-rated general health (RAND-36). Results: Self-management support needs are not related to illness duration. Patients who perceive their illness as episodic and/or progressively deteriorating have greater self-management support needs than patients who perceive their illness as stable. Deterioration of self-rated health is related to increased support needs. The effect of the course of illness on support needs depends on the type of selfmanagement activities. Conclusion: How chronically ill patients perceive the course of illness and actual changes in self-rated health are predictive for their need for support for self-management activities. Illness duration is not. Practice implications: Helping patients to self-manage should not be confined to the first years after diagnosis. Healthcare providers should be alert to patients’ own perceptions of their course of illness and health status. (aut.ref.)