Factors associated with self-management after hybrid revascularization in patients with peripheral artery disease: A structural equations model
- Authors
- Kim, So-Young; Lee, Yun Mi; Son, Youn-Jung
- Issue Date
- Jan-2023
- Publisher
- John Wiley and Sons Inc
- Keywords
- hybrid revascularization; lower extremity; nursing; patients; peripheral arterial disease; self-management; structural equation model
- Citation
- Journal of Advanced Nursing, v.79, no.1, pp 170 - 181
- Pages
- 12
- Journal Title
- Journal of Advanced Nursing
- Volume
- 79
- Number
- 1
- Start Page
- 170
- End Page
- 181
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/58783
- DOI
- 10.1111/jan.15440
- ISSN
- 0309-2402
1365-2648
- Abstract
- Aim: To investigate the factors associated with self-management after hybrid revascularization in patients with lower extremity peripheral artery disease using a structural equation modelling approach. Design: A cross-sectional study was adopted. Methods: A total of 221 patients who underwent hybrid revascularization for peripheral artery disease of the lower limbs were included from outpatient clinics at a 1200-bed tertiary care hospital in Korea. Data were collected using a self-reported questionnaire between December 1, 2019, and August 31, 2020. Structural equation modelling was applied to test the hypothetical model. Results: The item mean score of participants' self-management was 6.28 (standard deviation, 0.83) out of 8. The structural equation modelling had a good fit index. Autonomy support from healthcare providers was directly associated with self-management (β = 0.20, p = 0.041). Illness perception directly (β = −0.33, p = 0.031) and indirectly (β = −0.19, p = 0.032) influenced self-management through competence and relatedness in patients with peripheral artery disease. The construct of autonomy support from healthcare providers, illness perception, competence and relatedness accounted for 49% of the variance in self-management. The Sobel test confirmed the statistically significant mediating effects of competence (z = −4.52, p < 0.001) and relatedness (z = −2.12, p < 0.001) on the relationship between illness perception and self-management. Conclusion: Our findings revealed that autonomy support from healthcare providers and patients' illness perception directly influenced patients' self-management. Additionally, patients' illness perception can indirectly influence self-management through their perceived competence and relatedness. Impact: Healthcare providers' autonomy support to patients may promote self-care behaviours, leading to greater autonomous motivation. Assessment of patients' illness perception before patient education is vital to designing effective self-management strategies which can improve patients' perceived competency and meaningful relatedness with healthcare providers. © 2022 John Wiley & Sons Ltd.
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