title: Understanding older patients' self-management abilities: functional loss, self-management, and well-being.
abstract: OBJECTIVE
  This study aimed to increase our understanding of self-management abilities and identify better self-managers among older individuals.
  
  
  METHODS
  Our cross-sectional research was based on a pilot study of older people who had recently been admitted to a hospital. In the pilot study, all patients (>65 years of age) who were admitted to the Vlietland hospital between June and October 2010 were asked to participate, which led to the inclusion of 456 older patients at baseline. A total of 296 patients (65% response rate) were interviewed in their homes 3 months after admission. Measures included social, cognitive, and physical functioning, self-management abilities, and well-being. We used descriptive, correlations, and multiple regression analyses. In addition, we evaluated the mediation effect of self-management abilities on well-being.
  
  
  RESULTS
  Social, cognitive, and physical functioning significantly correlated with self-management abilities and well-being (all p ≤ 0.001). After controlling for background characteristics, multiple regression analysis indicated that social, cognitive, and physical functioning still related to self-management abilities (β = 0.17-0.25; all p ≤ 0.001). Older people with low levels of social, cognitive, and physical functioning were worse self-managers than were those with higher levels of functioning.
  
  
  CONCLUSIONS
  Self-management abilities mediate the relationship between social, cognitive, and physical functioning and well-being. Interventions to improve self-management abilities may help older people better deal with function losses as they age further.
authors.affiliation: Institute of Health Policy and Management (iBMG), Erasmus University, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands. cramm@bmg.eur.nl
authors.forename: J M
authors.initials: JM
authors.lastname: Cramm
authors.forename: J M
authors.initials: JM
authors.lastname: Hartgerink
authors.forename: E W
authors.initials: EW
authors.lastname: Steyerberg
authors.forename: T J
authors.initials: TJ
authors.lastname: Bakker
authors.forename: J P
authors.initials: JP
authors.lastname: Mackenbach
authors.forename: A P
authors.initials: AP
authors.lastname: Nieboer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010549:Personal Satisfaction; D010865:Pilot Projects; D011788:Quality of Life; D012044:Regression Analysis; D012648:Self Care / Q000523:psychology*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires