Symptom recognition as a mediator in the self-care of chronic illness
Riegel, Barbara, De Maria, Maddalena, Barbaranelli, Claudio, Matarese, Maria, Ausili, Davide, Stromberg, Anna, Vellone, Ercole and Jaarsma, Tiny. (2022). Symptom recognition as a mediator in the self-care of chronic illness. Frontiers in Public Health. 10, p. Article 883299. https://doi.org/10.3389/fpubh.2022.883299
|Authors||Riegel, Barbara, De Maria, Maddalena, Barbaranelli, Claudio, Matarese, Maria, Ausili, Davide, Stromberg, Anna, Vellone, Ercole and Jaarsma, Tiny|
Background: The recognition of a symptom is needed to initiate a decision to engage in a behavior to ameliorate the symptom. Yet, a surprising number of individuals fail to detect symptoms and delay in addressing early warnings of a health problem.
Purpose: The aim of this study was to test the hypothesis that symptom recognition mediates the relationship between monitoring for and management of symptoms of a chronic illness.
Methods: A secondary analysis of existing cross-sectional data. A sample of 1,629 patients diagnosed with one or more chronic conditions was enrolled in the United States (US) (n = 407), Italy (n = 784) and Sweden (n = 438) between March 2015 and May 2019. Data on self-care monitoring, symptom recognition, and self-care management was assessed using the Self-Care of Chronic Illness Inventory. After confirming metric invariance in cultural assessment, we used structural equation modeling to test a mediation model where symptom recognition was conceptualized as the mediator linking self-care monitoring and self-care management with autonomous (e.g., Change your activity level) and consulting behaviors (e.g., Call your healthcare provider for guidance).
Results: Symptom recognition mediated the relation between self-care monitoring and autonomous self-care management behaviors (β = 0.098, β = 0.122, β = 0.081, p < 0.001 for US, Italy, and Sweden, respectively). No mediation effect was found for consulting self-care management behaviors.
Conclusion: Our findings suggests that symptom recognition promotes autonomous self-care behaviors in people with a chronic condition. Self-care monitoring directly affects consulting self-care management behaviors but not through symptom recognition. Further research is needed to fully understand the role of symptom recognition in the self-care process.
|Keywords||self-care; self-management; chronic illness; chronic disease; symptom perception; interoception; mediation analysis; symptom recognition|
|Journal||Frontiers in Public Health|
|Journal citation||10, p. Article 883299|
|Publisher||Frontiers Research Foundation|
|Digital Object Identifier (DOI)||https://doi.org/10.3389/fpubh.2022.883299|
|PubMed Central ID||PMC9152258|
|Open access||Published as ‘gold’ (paid) open access|
File Access Level
|Online||17 May 2022|
|Publication process dates|
|Accepted||19 Apr 2022|
|Deposited||17 Mar 2023|
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