Trajectories and Influencing Factors of Self-Management Behaviour in Patients With Knee Osteoarthritis: A Longitudinal Study

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES Journal of evaluation in clinical practice Pub Date : 2025-02-07 DOI:10.1111/jep.70007

Lingjia Li, Xiangzhou Lan, Weike Zeng, Miao Chen, Ke Xue, Qing Chen

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Abstract

Aim

To explore the trajectory of self-management behaviour and its influencing factors in patients with knee osteoarthritis.

Design

This is a prospective, longitudinal observational study.

Methods

From January 2024 to April 2024, 126 patients with knee osteoarthritis who were hospitalized in two tertiary-level hospitals in Hunan Province were selected to be surveyed on the day of discharge, 1 month after discharge and 3 months after discharge using the Chinese version of the Chronic Disease Self-Management Research Measurement Scale. The trajectories of self-management behaviours were performed using latent category growth analysis. The influencing factors were performed using Lasso regression.

Results

Two classes were identified, including ‘slow decline class’ (37.1%) and ‘significant decline class’ (62.9%). Age, education, history of knee surgery and number of other chronic diseases combined were significant factors. Finally, older patients were more likely to be in the ‘significant decline group’ and patients with a history of knee surgery were more likely to be in the ‘slow decline group’.

Conclusion

We reported the existence of heterogeneity in self-management trajectories in patients with KOA and found that younger age and history of knee surgery were significantly associated with slow decline class trajectories. Further studies are needed to test the generalizability of these identified self-management trajectories in patients with KOA and their association with psychosocial aspects.

Implications for the Profession and Patient Care

To identify the trajectory of self-management behaviours of patients with KOA and explore their influencing factors, to provide reference for healthcare professionals to formulate targeted intervention programmes, so as to prevent the recurrence of knee osteoarthritis and delay the course of the disease.

Reporting Method

STROBE checklist was followed.

Patient or Public Contribution

The authors would specially thank all the participants in this study.

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膝骨关节炎患者自我管理行为轨迹及其影响因素：一项纵向研究

目的探讨膝关节骨性关节炎患者自我管理行为的发展轨迹及其影响因素。本研究为前瞻性、纵向观察性研究。方法选择2024年1月至2024年4月在湖南省两家三级医院住院的126例膝关节骨性关节炎患者，分别于出院当天、出院后1个月和出院后3个月采用中文版《慢性疾病自我管理研究测量量表》进行调查。自我管理行为的发展轨迹采用潜在类别增长分析。采用Lasso回归分析影响因素。结果分为“缓慢下降”（37.1%）和“显著下降”（62.9%）两类。年龄、受教育程度、膝关节手术史和其他慢性疾病的合并数量是显著因素。最后，老年患者更有可能属于“显著衰退组”，而有膝关节手术史的患者更有可能属于“缓慢衰退组”。结论：我们报道了KOA患者自我管理轨迹存在异质性，发现年龄较小和膝关节手术史与缓慢的下降类别轨迹显著相关。需要进一步的研究来检验这些确定的KOA患者自我管理轨迹的普遍性及其与社会心理方面的关联。了解膝骨性关节炎患者的自我管理行为轨迹，探讨其影响因素，为医护人员制定有针对性的干预方案提供参考，以预防膝骨性关节炎复发，延缓病程。报告方法采用STROBE检查表。作者在此特别感谢所有参与本研究的人。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.