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Patient activation and psychological coping strategies to manage challenging circumstances during the COVID-19 pandemic in people with kidney disease

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Version 2 2024-05-09, 10:57
Version 1 2023-12-18, 16:01
journal contribution
posted on 2024-05-09, 10:57 authored by Courtney Lightfoot, Thomas Wilkinson, Naeema Patel, Ceri Jones, Alice Smith

Background

Coping with health problems requires some degree of self-management; however, an individual’s ability to self-manage can be threatened during challenging times, such as the COVID-19 pandemic. Exploring differences and changes in psychological well-being and coping strategies between those with low and high patient activation may inform appropriate interventions to support psychological coping.


Methods

People with chronic kidney disease (CKD) (non-dialysis and transplant) were recruited from 11 hospital sites across England between August and December 2020. Participants responded to an online survey study, including the Brief Coping Orientation to Problem Experienced (COPE) Inventory, Depression, Anxiety and Stress Scale (DASS-21), Short Health Anxiety Index (SHAI), and Patient Activation Measure (PAM-13). A follow-up survey was conducted 6–9 months later. Paired t tests assessed within-group changes, and chi-squared tests compared coping strategies utilised by low- and high-activated participants. General linear modelling was performed to determine the relationship between patient activation and coping strategies, and covariates.


Results

Two hundred and fourteen participants were recruited (mean age: 60.7, 51% male, mean eGFR: 38.9 ml/min/1.73 m2). Low-activated participants were significantly more anxious than high-activated participants (P = 0.045). Health anxiety significantly decreased (i.e., got better) for high-activated participants (P = 0.016). Higher patient activation scores were associated with greater use of problem-focused strategies (β = 0.288, P < 0.001). Age (β = − 0.174, P = 0.012), sex (β = 0.188, P = 0.004), and education level (β = 0.159, P = 0.019) significantly predicted use of problem-focused strategies.


Discussion

Those with higher activation had lower levels of anxiety, and more frequently used adaptive coping strategies during the pandemic. Targeted support and interventions may be required for people with CKD to enhance patient activation, encourage more positive adaptive coping strategies, and mitigate maladaptive coping strategies.

Funding

National Institute of Health and Care Research (NIHR)Applied Research Collaboration East Midlands (ARC-EM)

Stoneygate Trust

IHR Leicester Biomedical Research Centre (BRC)

History

Author affiliation

Department of Health Sciences, University of Leicester

Version

  • VoR (Version of Record)

Published in

Journal of Nephrology

Volume

37

Pagination

353-364

Publisher

Springer Verlag

issn

1724-6059

Copyright date

2023

Language

en

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