Correlation Between Health Empowerment,Self-Management And Care Dependency In Patients With Elderly Multimorbidity

ObjectiveTo investigate the status quo of health empowerment,self-management and care dependence in patients with elderly multimorbidity,analyze the correlation between health empowerment,self-management and care dependence in patients with elderly multimorbidity,and explore the mediating role of self-management in health empowerment and care dependence.It provides an important basis for reducing care dependence of patients and improving quality of life.MethodsA cross-sectional survey method was adopted to select 266 elderly multimorbidity patients who met the exclusion standard in a third-class A hospital in Dalian City from March 2022 to October 2022 as research objects for questionnaire survey,including general data questionnaire,health empowerment scale for elderly patients with chronic diseases,health self-management assessment scale for chronic diseases,and care dependency scale.After screening,the data were input into Excel in time.SPSS 25.0 software was used to describe the scores of general information,health empowerment,self-management and care dependence of elderly multimorbidity patients by statistical description method.Independent sample t test,one-way variance analysis and multifactor regression analysis were used to determine the influence of demographic data on care dependence of senile comorbis.Pearson correlation analysis was used to analyze the total score of the three variables and the correlation among each dimension.AMOS 24.0 was used to construct a structural equation model to further verify the mediating role of self-management in health empowerment and care dependency.Results1.In this study,the incidence of nursing dependence of middle-aged and elderly patients with comorbiditis accounted for 89%,among which almost independent,a little dependent,a part dependent,a large part dependent and a complete dependent accounted for 11%,29%,51%,8% and 1%,respectively.The average score of nursing dependence was(57.65±9.02)points.The average score of health empowerment was(80.65±14.64);The average score of self-management was(157.46±28.10)points.2.The results of independent sample t test and one-way analysis of variance showed that age,educational level,per capita monthly income,nutritional status,number of diseases,mild cognitive impairment or physical impairment had significant differences in care dependence scores,with statistical significance(P<0.05).Multivariate regression analysis showed that age,educational level,nutritional status,number of diseases,health empowerment and self-management were the main influencing factors of care dependency(P< 0.05).3.Health empowerment score in patients with elderly multimorbidity was positively correlated with care dependence score(r=0.439,P<0.01).Self-management score was positively correlated with nursing dependence score(r=0.433,P<0.01).The level of health empowerment and self-management is negatively correlated with the degree of care dependence,that is,the higher the level of health empowerment,the lower the degree of care dependence.The higher the level of self-management,the lower the degree of care dependence.4.The results of mediating effect test showed that self-management played a partial mediating role between health empowerment and care dependence in patients with elderly multimorbidity,accounting for 38.7% of the total effect.Conclusion1.Nursing dependence of senile comorbidities is high,with 60% of patients having partial dependence or above;Both health empowerment and self-management are below average.2.The care dependence degree of elderly patients with multiple diseases is affected by age,education level,nutritional status,number of diseases,health empowerment and self-management level.Medical staff should focus on elderly patients with low education,malnutrition and high number of diseases,improve their health empowerment and self-management level,make early assessment and intervention,and reduce their care dependence degree.3.Self-management plays a partial mediating role in the influence of health empowerment on nursing dependence of senile comorbidities.Health empowerment can indirectly influence nursing dependence of senile comorbidities through self-management.In future clinical work,medical staff should continuously increase patients’ medical knowledge to enhance their health empowerment,improve patients’ self-management by improving their cognitive ability,and continue to explore intervention measures to reduce nursing dependence of senile comorbid patients,so as to make contributions to reducing the social burden.